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This is VAERS ID 284776

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

284776
VAERS Form:
Age:13.0
Gender:Male
Location:Wisconsin
Vaccinated:2007-06-29
Onset:2007-07-06
Submitted:2007-07-13
Entered:2007-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0389U / 0 RA / UN
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U1996AA / 0 LA / UN

Administered by: Private      Purchased by: Unknown
Symptoms: Facial palsy, Red blood cell sedimentation rate normal, Borrelia burgdorferi serology negative

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: ESR 13 Lyme titer 0.58 records received 7/19/07- Lyme titer negative.
CDC 'Split Type':

Write-up:(R) facial nerve palsy Treatment-Doxycycline 100 mg po bid Prednisone 50 mg po dd x 5 dy 7/19/07-records received-7/6/07 seen in ED. 7/12/07 follow-up visit. Right facial nerve pasy. No headaches, no fever no ear pain. Improved mobility, noticing that she"is able to open and close her eye a little bit more, able to close eye 90% of way. . Speech better. No associated weakness. No joint swelling


Changed on 12/8/2009

284776 Before After
VAERS Form:
Age:13.0
Gender:Male Female
Location:Wisconsin
Vaccinated:2007-06-29
Onset:2007-07-06
Submitted:2007-07-13
Entered:2007-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0389U / 0 RA / UN
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U1996AA / 0 LA / UN

Administered by: Private      Purchased by: Unknown Private
Symptoms: Facial palsy, Red blood cell sedimentation rate normal, Borrelia burgdorferi serology negative

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: ESR 13 Lyme titer 0.58 records received 7/19/07- Lyme titer negative.
CDC 'Split Type':

Write-up:(R) facial nerve palsy Treatment-Doxycycline 100 mg po bid Prednisone 50 mg po dd x 5 dy 7/19/07-records received-7/6/07 seen in ED. 7/12/07 follow-up visit. Right facial nerve pasy. No headaches, no fever no ear pain. Improved mobility, noticing that she"is she is able to open and close her eye a little bit more, able to close eye 90% of way. . Speech better. No associated weakness. No joint swelling


Changed on 4/7/2010

284776 Before After
VAERS Form:
Age:13.0
Gender:Female
Location:Wisconsin
Vaccinated:2007-06-29
Onset:2007-07-06
Submitted:2007-07-13
Entered:2007-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0389U / 0 RA / UN
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1996AA / 0 LA / UN

Administered by: Private      Purchased by: Private
Symptoms: Facial palsy, Red blood cell sedimentation rate normal, Borrelia burgdorferi serology negative

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: ESR 13 Lyme titer 0.58 records received 7/19/07- Lyme titer negative.
CDC 'Split Type':

Write-up:(R) facial nerve palsy Treatment-Doxycycline 100 mg po bid Prednisone 50 mg po dd x 5 dy 7/19/07-records received-7/6/07 seen in ED. 7/12/07 follow-up visit. Right facial nerve pasy. No headaches, no fever no ear pain. Improved mobility, noticing that she is able to open and close her eye a little bit more, able to close eye 90% of way. . Speech better. No associated weakness. No joint swelling


Changed on 5/14/2017

284776 Before After
VAERS Form:
Age:13.0
Gender:Female
Location:Wisconsin
Vaccinated:2007-06-29
Onset:2007-07-06
Submitted:2007-07-13
Entered:2007-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0389U / 0 RA / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1996AA / 0 LA / UN

Administered by: Private      Purchased by: Private
Symptoms: Facial palsy, Red blood cell sedimentation rate normal, Borrelia burgdorferi serology negative

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: ESR 13 Lyme titer 0.58 records received 7/19/07- Lyme titer negative.
CDC 'Split Type':

Write-up:(R) facial nerve palsy Treatment-Doxycycline 100 mg po bid Prednisone 50 mg po dd x 5 dy 7/19/07-records received-7/6/07 seen in ED. 7/12/07 follow-up visit. Right facial nerve pasy. No headaches, no fever no ear pain. Improved mobility, noticing that she is able to open and close her eye a little bit more, able to close eye 90% of way. . Speech better. No associated weakness. No joint swelling


Changed on 9/14/2017

284776 Before After
VAERS Form:(blank) 1
Age:13.0
Gender:Female
Location:Wisconsin
Vaccinated:2007-06-29
Onset:2007-07-06
Submitted:2007-07-13
Entered:2007-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0389U / 0 1 RA / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1996AA / 0 1 LA / UN

Administered by: Private      Purchased by: Private
Symptoms: Facial palsy, Red blood cell sedimentation rate normal

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: ESR 13 Lyme titer 0.58 records received 7/19/07- Lyme titer negative.
CDC 'Split Type':

Write-up:(R) facial nerve palsy Treatment-Doxycycline 100 mg po bid Prednisone 50 mg po dd x 5 dy 7/19/07-records received-7/6/07 seen in ED. 7/12/07 follow-up visit. Right facial nerve pasy. No headaches, no fever no ear pain. Improved mobility, noticing that she is able to open and close her eye a little bit more, able to close eye 90% of way. . Speech better. No associated weakness. No joint swelling


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