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This is VAERS ID 295176

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

295176
VAERS Form:
Age:15.0
Gender:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-10-31
Entered:2007-11-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Other      Purchased by: Unknown
Symptoms: Dizziness, Gait disturbance, Hypoaesthesia, Pain in extremity

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: Doryx
Current Illness: Acne
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type':

Write-up:Information has been received from a physician, concerning her relative, a /"15 or 16/" year old female student with acne, who on an unknown date was vaccinated with the second dose of Gardasil (lot # not provided). Concomitant therapy included doxycyclin"e byclate (DORYX). Following the vaccination, the student experienced arm pain, lightheadedness, generalized body numbness and a shuffling gait. The student also planned to see her family physician. At the time of this report, the student had not recovere


Changed on 12/8/2009

295176 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-10-31
Entered:2007-11-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Other      Purchased by: Unknown Other
Symptoms: Dizziness, Gait disturbance, Hypoaesthesia, Pain in extremity

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: Doryx
Current Illness: Acne
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': (blank) WAES0710USA05676

Write-up:Information has been received from a physician, concerning her relative, a /"15 "15 or 16/" 16" year old female student with acne, who on an unknown date was vaccinated with the second dose of Gardasil (lot # not provided). Concomitant therapy included doxycyclin"e doxycycline byclate (DORYX). Following the vaccination, the student experienced arm pain, lightheadedness, generalized body numbness and a shuffling gait. The student also planned to see her family physician. At the time of this report, the student had not recovere recovered from the events. The physician considered the events to be disabling, as the student had missed time in school. Additional information has been requested.


Changed on 9/14/2017

295176 Before After
VAERS Form:(blank) 1
Age:15.0
Gender:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-10-31
Entered:2007-11-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 2 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Dizziness, Gait disturbance, Hypoaesthesia, Pain in extremity

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: Doryx
Current Illness: Acne
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0710USA05676

Write-up:Information has been received from a physician, concerning her relative, a "15 or 16" year old female student with acne, who on an unknown date was vaccinated with the second dose of Gardasil (lot # not provided). Concomitant therapy included doxycycline byclate (DORYX). Following the vaccination, the student experienced arm pain, lightheadedness, generalized body numbness and a shuffling gait. The student also planned to see her family physician. At the time of this report, the student had not recovered from the events. The physician considered the events to be disabling, as the student had missed time in school. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=295176&WAYBACKHISTORY=ON


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