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This is VAERS ID 279174

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 279174
Age:17.0
Gender:Female
Location:New Jersey
Vaccinated:2006-12-04
Onset:2007-01-01
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Other      Purchased by: Unknown
Symptoms: Dizziness, Electroencephalogram normal, Fall, Gait disturbance, Basilar migraine

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Headache
Preexisting Conditions:
Diagnostic Lab Data: electroencephalography - negative magnetic resonance - negative hematology - negative
CDC 'Split Type':

Write-up:Information has been received from a physician concerning a 17 year old female patient with headache who on 09-OCT-2006 was vaccinated with a first dose 0.5 mL of Gardasil and on 04-DEC-2006 with a second dose 0.5 mL of Gardasil. In last week of January 2"007, patient was dizzy, felt paralyzed, fell and needed to hold onto something to walk. This lasted for 5 minutes. This was immediately followed with nausea and a /"wavy like vision that looked like a kaleidoscope./" This lasted for 30 minutes, possible v


Changed on 12/8/2009

VAERS ID: 279174 Before After
Age:17.0
Gender:Female
Location:New Jersey
Vaccinated:2006-12-04
Onset:2007-01-01
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Other      Purchased by: Unknown Other
Symptoms: Dizziness, Electroencephalogram normal, Fall, Gait disturbance, Nausea, Nuclear magnetic resonance imaging normal, Syncope vasovagal, Visual disturbance, Basilar migraine, Haematology test normal

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Headache
Preexisting Conditions:
Diagnostic Lab Data: electroencephalography - negative magnetic resonance - negative hematology - negative
CDC 'Split Type': (blank) WAES0704USA01346

Write-up:Information has been received from a physician concerning a 17 year old female patient with headache who on 09-OCT-2006 was vaccinated with a first dose 0.5 mL of Gardasil and on 04-DEC-2006 with a second dose 0.5 mL of Gardasil. In last week of January 2"007, 2007, patient was dizzy, felt paralyzed, fell and needed to hold onto something to walk. This lasted for 5 minutes. This was immediately followed with nausea and a /"wavy "wavy like vision that looked like a kaleidoscope./" kaleidoscope." This lasted for 30 minutes, possible v vasovagal reaction. On 04-DEC-2004 she also had her ears pierced. She was seen by her internist and then a neurologist. She had blood tests, magnetic resonance imaging (MRI) and electroencephalography (EEG), all were negative. Patient''s diagnosis was basal artery migraine. She was treated with Periactin. The patient was reported as recovering. Additional information has been requested.


Changed on 3/2/2010

VAERS ID: 279174 Before After
Age:17.0
Gender:Female
Location:New Jersey
Vaccinated:2006-12-04
Onset:2007-01-01
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Dizziness, Electroencephalogram normal, Fall, Gait disturbance, Nausea, Nuclear magnetic resonance imaging normal, Syncope vasovagal, Visual disturbance, Basilar migraine, Haematology test normal

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Headache
Preexisting Conditions:
Diagnostic Lab Data: electroencephalography - negative magnetic resonance - negative hematology - negative
CDC 'Split Type': WAES0704USA01346

Write-up:Information has been received from a physician concerning a 17 year old female patient with headache who on 09-OCT-2006 was vaccinated with a first dose 0.5 mL of Gardasil and on 04-DEC-2006 with a second dose 0.5 mL of Gardasil. In last week of January 2007, patient was dizzy, felt paralyzed, fell and needed to hold onto something to walk. This lasted for 5 minutes. This was immediately followed with nausea and a "wavy like vision that looked like a kaleidoscope." This lasted for 30 minutes, possible vasovagal reaction. On 04-DEC-2004 she also had her ears pierced. She was seen by her internist and then a neurologist. She had blood tests, magnetic resonance imaging (MRI) and electroencephalography (EEG), all were negative. Patient''s diagnosis was basal artery migraine. She was treated with Periactin. The patient was reported as recovering. Additional information has been requested. 07/06/07 This is in follow-up to report(s) previously submitted on 5/14/2007. No additional information is expected.


Changed on 6/14/2014

VAERS ID: 279174 Before After
Age:17.0
Gender:Female
Location:New Jersey
Vaccinated:2006-12-04
Onset:2007-01-01
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Dizziness, Electroencephalogram normal, Fall, Gait disturbance, Nausea, Nuclear magnetic resonance imaging normal, Syncope vasovagal, Visual disturbance, Basilar migraine, Haematology test normal

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Headache
Preexisting Conditions:
Diagnostic Lab Data: electroencephalography - negative magnetic resonance - negative hematology - negative
CDC 'Split Type': WAES0704USA01346

Write-up:Information has been received from a physician concerning a 17 year old female patient with headache who on 09-OCT-2006 was vaccinated with a first dose 0.5 mL of Gardasil and on 04-DEC-2006 with a second dose 0.5 mL of Gardasil. In last week of January 2007, patient was dizzy, felt paralyzed, fell and needed to hold onto something to walk. This lasted for 5 minutes. This was immediately followed with nausea and a "wavy like vision that looked like a kaleidoscope." This lasted for 30 minutes, possible vasovagal reaction. On 04-DEC-2004 she also had her ears pierced. She was seen by her internist and then a neurologist. She had blood tests, magnetic resonance imaging (MRI) and electroencephalography (EEG), all were negative. Patient''s diagnosis was basal artery migraine. She was treated with Periactin. The patient was reported as recovering. Additional information has been requested. 07/06/07 This is in follow-up to report(s) previously submitted on 5/14/2007. No additional information is expected.


Changed on 5/14/2017

VAERS ID: 279174 Before After
Age:17.0
Gender:Female
Location:New Jersey
Vaccinated:2006-12-04
Onset:2007-01-01
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Dizziness, Electroencephalogram normal, Fall, Gait disturbance, Nausea, Nuclear magnetic resonance imaging normal, Syncope vasovagal, Visual disturbance, Basilar migraine, Haematology test normal

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Headache
Preexisting Conditions:
Diagnostic Lab Data: electroencephalography - negative magnetic resonance - negative hematology - negative
CDC 'Split Type': WAES0704USA01346

Write-up:Information has been received from a physician concerning a 17 year old female patient with headache who on 09-OCT-2006 was vaccinated with a first dose 0.5 mL of Gardasil and on 04-DEC-2006 with a second dose 0.5 mL of Gardasil. In last week of January 2007, patient was dizzy, felt paralyzed, fell and needed to hold onto something to walk. This lasted for 5 minutes. This was immediately followed with nausea and a "wavy like vision that looked like a kaleidoscope." This lasted for 30 minutes, possible vasovagal reaction. On 04-DEC-2004 she also had her ears pierced. She was seen by her internist and then a neurologist. She had blood tests, magnetic resonance imaging (MRI) and electroencephalography (EEG), all were negative. Patient''s diagnosis was basal artery migraine. She was treated with Periactin. The patient was reported as recovering. Additional information has been requested. 07/06/07 This is in follow-up to report(s) previously submitted on 5/14/2007. No additional information is expected.


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