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This is VAERS ID 284624

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

284624
VAERS Form:
Age:12.0
Gender:Female
Location:Massachusetts
Vaccinated:2007-06-05
Onset:2007-06-07
Submitted:2007-07-12
Entered:2007-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0387U / 0 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Tic

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: ADHD
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up:Simple motor tic- shrugging shoulder, persistent x 1 month, 1st noted approximately 2d after Gardasil vaccine.


Changed on 12/8/2009

284624 Before After
VAERS Form:
Age:12.0
Gender:Female
Location:Massachusetts
Vaccinated:2007-06-05
Onset:2007-06-07
Submitted:2007-07-12
Entered:2007-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0387U / 0 LA / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Tic

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: ADHD
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up:Simple motor tic- shrugging shoulder, persistent x 1 month, 1st noted approximately 2d after Gardasil vaccine.


Changed on 9/14/2017

284624 Before After
VAERS Form:(blank) 1
Age:12.0
Gender:Female
Location:Massachusetts
Vaccinated:2007-06-05
Onset:2007-06-07
Submitted:2007-07-12
Entered:2007-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0387U / 0 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Tic

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: ADHD
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up:Simple motor tic- shrugging shoulder, persistent x 1 month, 1st noted approximately 2d after Gardasil vaccine.


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