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This is VAERS ID 281051

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

281051
VAERS Form:
Age:8.0
Gender:Female
Location:New York
Vaccinated:2002-04-04
Onset:2007-06-03
Submitted:2007-06-08
Entered:2007-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1426F / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U2158AA / 0 RA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Dyskinesia, Facial palsy, Facial paresis, Borrelia burgdorferi serology, Hypoaesthesia facial

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Lyme titers sent and pending. Thyroid function within normal limits.
CDC 'Split Type':

Write-up:2 months following vaccine administration patient developed Bell''''s Palsy. Treated with Valtrex and prednisone.


Changed on 12/8/2009

281051 Before After
VAERS Form:
Age:8.0
Gender:Female
Location:New York
Vaccinated:2002-04-04
Onset:2007-06-03
Submitted:2007-06-08
Entered:2007-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1426F / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U2158AA / 0 RA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Dyskinesia, Facial palsy, Lyme disease, Ophthalmoplegia, Thyroid function test normal, Facial paresis, Borrelia burgdorferi serology, Hypoaesthesia facial

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Lyme titers sent and pending. Thyroid function within normal limits.
CDC 'Split Type':

Write-up:2 months following vaccine administration patient developed Bell''''s Bell''s Palsy. Treated with Valtrex and prednisone. 7/26/07 Received call from pcp w/additional patient information. States Lyme test initially reported as neg has now been determined to be positive. Feels Bells palsy secondary to Lymes disease & not related to vaccine. 8/31/07 Reviewed pcp medical records which included vax records & corrected vax info. VAERS database updated w/same. Office note of 4/4/07 reveals patient healthy on day of vax, only concern was acne. Returned on 6/7/07 w/left side facial weakness x 4 days. Unable to lift left eyebrow or close left eye. Unable to smile on left side. Tx w/antiviral & prednisone, eye drops & eye patch at night. Returned 6/26/07. Lyme titers had returned (+). Facial numbness & weakness had improved. Smile remained slightly asymmetrical but able to lift eyebrow & squeeze eyes shut. Tx w/antibiotics & received 2nd dose Gardisil. Returned 7/24/07. Had completed meds & symptoms had improved & smile now symmetrical. FINAL DX: Bell''s Palsy secondary to Lyme''s disease.


Changed on 4/7/2010

281051 Before After
VAERS Form:
Age:8.0
Gender:Female
Location:New York
Vaccinated:2002-04-04
Onset:2007-06-03
Submitted:2007-06-08
Entered:2007-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1426F / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2158AA / 0 RA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Dyskinesia, Facial palsy, Lyme disease, Ophthalmoplegia, Thyroid function test normal, Facial paresis, Borrelia burgdorferi serology, Hypoaesthesia facial

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Lyme titers sent and pending. Thyroid function within normal limits.
CDC 'Split Type':

Write-up:2 months following vaccine administration patient developed Bell''s Palsy. Treated with Valtrex and prednisone. 7/26/07 Received call from pcp w/additional patient information. States Lyme test initially reported as neg has now been determined to be positive. Feels Bells palsy secondary to Lymes disease & not related to vaccine. 8/31/07 Reviewed pcp medical records which included vax records & corrected vax info. VAERS database updated w/same. Office note of 4/4/07 reveals patient healthy on day of vax, only concern was acne. Returned on 6/7/07 w/left side facial weakness x 4 days. Unable to lift left eyebrow or close left eye. Unable to smile on left side. Tx w/antiviral & prednisone, eye drops & eye patch at night. Returned 6/26/07. Lyme titers had returned (+). Facial numbness & weakness had improved. Smile remained slightly asymmetrical but able to lift eyebrow & squeeze eyes shut. Tx w/antibiotics & received 2nd dose Gardisil. Returned 7/24/07. Had completed meds & symptoms had improved & smile now symmetrical. FINAL DX: Bell''s Palsy secondary to Lyme''s disease.


Changed on 10/5/2010

281051 Before After
VAERS Form:
Age:8.0 13.0
Gender:Female
Location:New York
Vaccinated:2002-04-04 2007-04-04
Onset:2007-06-03
Submitted:2007-06-08
Entered:2007-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1426F / 0 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2158AA / 0 RA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Dyskinesia, Facial palsy, Lyme disease, Ophthalmoplegia, Thyroid function test normal, Facial paresis, Borrelia burgdorferi serology, Hypoaesthesia facial

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Lyme titers sent and pending. Thyroid function within normal limits.
CDC 'Split Type':

Write-up:2 months following vaccine administration patient developed Bell''s Palsy. Treated with Valtrex and prednisone. 7/26/07 Received call from pcp w/additional patient information. States Lyme test initially reported as neg has now been determined to be positive. Feels Bells palsy secondary to Lymes disease & not related to vaccine. 8/31/07 Reviewed pcp medical records which included vax records & corrected vax info. VAERS database updated w/same. Office note of 4/4/07 reveals patient healthy on day of vax, only concern was acne. Returned on 6/7/07 w/left side facial weakness x 4 days. Unable to lift left eyebrow or close left eye. Unable to smile on left side. Tx w/antiviral & prednisone, eye drops & eye patch at night. Returned 6/26/07. Lyme titers had returned (+). Facial numbness & weakness had improved. Smile remained slightly asymmetrical but able to lift eyebrow & squeeze eyes shut. Tx w/antibiotics & received 2nd dose Gardisil. Returned 7/24/07. Had completed meds & symptoms had improved & smile now symmetrical. FINAL DX: Bell''s Palsy secondary to Lyme''s disease.


Changed on 4/13/2011

281051 Before After
VAERS Form:
Age:13.0
Gender:Female
Location:New York
Vaccinated:2007-04-04
Onset:2007-06-03
Submitted:2007-06-08
Entered:2007-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1426F / 0 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2158AA / 0 RA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Dyskinesia, Facial palsy, Lyme disease, Ophthalmoplegia, Thyroid function test normal, Facial paresis, Borrelia burgdorferi serology, Hypoaesthesia facial

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Lyme titers sent and pending. Thyroid function within normal limits.
CDC 'Split Type':

Write-up:2 months following vaccine administration patient developed Bell''s Palsy. Treated with Valtrex and prednisone. 7/26/07 Received call from pcp w/additional patient information. States Lyme test initially reported as neg has now been determined to be positive. Feels Bells palsy secondary to Lymes disease & not related to vaccine. 8/31/07 Reviewed pcp medical records which included vax records & corrected vax info. VAERS database updated w/same. Office note of 4/4/07 reveals patient healthy on day of vax, only concern was acne. Returned on 6/7/07 w/left side facial weakness x 4 days. Unable to lift left eyebrow or close left eye. Unable to smile on left side. Tx w/antiviral & prednisone, eye drops & eye patch at night. Returned 6/26/07. Lyme titers had returned (+). Facial numbness & weakness had improved. Smile remained slightly asymmetrical but able to lift eyebrow & squeeze eyes shut. Tx w/antibiotics & received 2nd dose Gardisil. Returned 7/24/07. Had completed meds & symptoms had improved & smile now symmetrical. FINAL DX: Bell''s Palsy secondary to Lyme''s disease.


Changed on 5/13/2011

281051 Before After
VAERS Form:
Age:13.0
Gender:Female
Location:New York
Vaccinated:2007-04-04
Onset:2007-06-03
Submitted:2007-06-08
Entered:2007-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1426F / 0 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2158AA / 0 RA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Dyskinesia, Facial palsy, Lyme disease, Ophthalmoplegia, Thyroid function test normal, Facial paresis, Borrelia burgdorferi serology, Hypoaesthesia facial

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Lyme titers sent and pending. Thyroid function within normal limits.
CDC 'Split Type':

Write-up:2 months following vaccine administration patient developed Bell''s Palsy. Treated with Valtrex and prednisone. 7/26/07 Received call from pcp w/additional patient information. States Lyme test initially reported as neg has now been determined to be positive. Feels Bells palsy secondary to Lymes disease & not related to vaccine. 8/31/07 Reviewed pcp medical records which included vax records & corrected vax info. VAERS database updated w/same. Office note of 4/4/07 reveals patient healthy on day of vax, only concern was acne. Returned on 6/7/07 w/left side facial weakness x 4 days. Unable to lift left eyebrow or close left eye. Unable to smile on left side. Tx w/antiviral & prednisone, eye drops & eye patch at night. Returned 6/26/07. Lyme titers had returned (+). Facial numbness & weakness had improved. Smile remained slightly asymmetrical but able to lift eyebrow & squeeze eyes shut. Tx w/antibiotics & received 2nd dose Gardisil. Returned 7/24/07. Had completed meds & symptoms had improved & smile now symmetrical. FINAL DX: Bell''s Palsy secondary to Lyme''s disease.


Changed on 6/11/2011

281051 Before After
VAERS Form:
Age:13.0
Gender:Female
Location:New York
Vaccinated:2007-04-04
Onset:2007-06-03
Submitted:2007-06-08
Entered:2007-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1426F / 0 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2158AA / 0 RA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Dyskinesia, Facial palsy, Lyme disease, Ophthalmoplegia, Thyroid function test normal, Facial paresis, Borrelia burgdorferi serology, Hypoaesthesia facial

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Lyme titers sent and pending. Thyroid function within normal limits.
CDC 'Split Type':

Write-up:2 months following vaccine administration patient developed Bell''s Palsy. Treated with Valtrex and prednisone. 7/26/07 Received call from pcp w/additional patient information. States Lyme test initially reported as neg has now been determined to be positive. Feels Bells palsy secondary to Lymes disease & not related to vaccine. 8/31/07 Reviewed pcp medical records which included vax records & corrected vax info. VAERS database updated w/same. Office note of 4/4/07 reveals patient healthy on day of vax, only concern was acne. Returned on 6/7/07 w/left side facial weakness x 4 days. Unable to lift left eyebrow or close left eye. Unable to smile on left side. Tx w/antiviral & prednisone, eye drops & eye patch at night. Returned 6/26/07. Lyme titers had returned (+). Facial numbness & weakness had improved. Smile remained slightly asymmetrical but able to lift eyebrow & squeeze eyes shut. Tx w/antibiotics & received 2nd dose Gardisil. Returned 7/24/07. Had completed meds & symptoms had improved & smile now symmetrical. FINAL DX: Bell''s Palsy secondary to Lyme''s disease.


Changed on 6/14/2014

281051 Before After
VAERS Form:
Age:13.0
Gender:Female
Location:New York
Vaccinated:2007-04-04
Onset:2007-06-03
Submitted:2007-06-08
Entered:2007-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1426F / 0 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2158AA / 0 RA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Dyskinesia, Facial palsy, Lyme disease, Ophthalmoplegia, Thyroid function test normal, Facial paresis, Borrelia burgdorferi serology, Hypoaesthesia facial

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Lyme titers sent and pending. Thyroid function within normal limits.
CDC 'Split Type':

Write-up:2 months following vaccine administration patient developed Bell''s Palsy. Treated with Valtrex and prednisone. 7/26/07 Received call from pcp w/additional patient information. States Lyme test initially reported as neg has now been determined to be positive. Feels Bells palsy secondary to Lymes disease & not related to vaccine. 8/31/07 Reviewed pcp medical records which included vax records & corrected vax info. VAERS database updated w/same. Office note of 4/4/07 reveals patient healthy on day of vax, only concern was acne. Returned on 6/7/07 w/left side facial weakness x 4 days. Unable to lift left eyebrow or close left eye. Unable to smile on left side. Tx w/antiviral & prednisone, eye drops & eye patch at night. Returned 6/26/07. Lyme titers had returned (+). Facial numbness & weakness had improved. Smile remained slightly asymmetrical but able to lift eyebrow & squeeze eyes shut. Tx w/antibiotics & received 2nd dose Gardisil. Returned 7/24/07. Had completed meds & symptoms had improved & smile now symmetrical. FINAL DX: Bell''s Palsy secondary to Lyme''s disease.


Changed on 5/14/2017

281051 Before After
VAERS Form:
Age:13.0
Gender:Female
Location:New York
Vaccinated:2007-04-04
Onset:2007-06-03
Submitted:2007-06-08
Entered:2007-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1426F / 0 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2158AA / 0 RA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Dyskinesia, Facial palsy, Lyme disease, Ophthalmoplegia, Thyroid function test normal, Facial paresis, Borrelia burgdorferi serology, Hypoaesthesia facial

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Lyme titers sent and pending. Thyroid function within normal limits.
CDC 'Split Type':

Write-up:2 months following vaccine administration patient developed Bell''s Palsy. Treated with Valtrex and prednisone. 7/26/07 Received call from pcp w/additional patient information. States Lyme test initially reported as neg has now been determined to be positive. Feels Bells palsy secondary to Lymes disease & not related to vaccine. 8/31/07 Reviewed pcp medical records which included vax records & corrected vax info. VAERS database updated w/same. Office note of 4/4/07 reveals patient healthy on day of vax, only concern was acne. Returned on 6/7/07 w/left side facial weakness x 4 days. Unable to lift left eyebrow or close left eye. Unable to smile on left side. Tx w/antiviral & prednisone, eye drops & eye patch at night. Returned 6/26/07. Lyme titers had returned (+). Facial numbness & weakness had improved. Smile remained slightly asymmetrical but able to lift eyebrow & squeeze eyes shut. Tx w/antibiotics & received 2nd dose Gardisil. Returned 7/24/07. Had completed meds & symptoms had improved & smile now symmetrical. FINAL DX: Bell''s Palsy secondary to Lyme''s disease.


Changed on 9/14/2017

281051 Before After
VAERS Form:(blank) 1
Age:13.0
Gender:Female
Location:New York
Vaccinated:2007-04-04
Onset:2007-06-03
Submitted:2007-06-08
Entered:2007-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1426F / 0 1 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2158AA / 0 1 RA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Facial palsy, Thyroid function test normal, Borrelia burgdorferi serology

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Lyme titers sent and pending. Thyroid function within normal limits.
CDC 'Split Type':

Write-up:2 months following vaccine administration patient developed Bell''s Palsy. Treated with Valtrex and prednisone. 7/26/07 Received call from pcp w/additional patient information. States Lyme test initially reported as neg has now been determined to be positive. Feels Bells palsy secondary to Lymes disease & not related to vaccine. 8/31/07 Reviewed pcp medical records which included vax records & corrected vax info. VAERS database updated w/same. Office note of 4/4/07 reveals patient healthy on day of vax, only concern was acne. Returned on 6/7/07 w/left side facial weakness x 4 days. Unable to lift left eyebrow or close left eye. Unable to smile on left side. Tx w/antiviral & prednisone, eye drops & eye patch at night. Returned 6/26/07. Lyme titers had returned (+). Facial numbness & weakness had improved. Smile remained slightly asymmetrical but able to lift eyebrow & squeeze eyes shut. Tx w/antibiotics & received 2nd dose Gardisil. Returned 7/24/07. Had completed meds & symptoms had improved & smile now symmetrical. FINAL DX: Bell''s Palsy secondary to Lyme''s disease.


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