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This is VAERS ID 316760

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2008

VAERS ID: 316760
Age:14.0
Gender:Female
Location:Florida
Vaccinated:2008-05-05
Onset:2008-05-16
Submitted:2008-06-20
Entered:2008-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Private      Purchased by: Unknown
Symptoms: Abdominal pain, CSF oligoclonal band present, Diplopia, Albumin CSF increased, Blood test

Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: dizziness, sight, numbness
Preexisting Conditions: none
Diagnostic Lab Data: MRI; lumbar puncture; blood 2nd dose; diagnosed with ADEM 8/6/08-records received for DOS 6/10-6/13/08-DC DX: ADEM. CSF albumin increased 5120, olig bands increased 11. EBV VCA IGG positive. MRI abnormal .with left periventricular white ma
CDC 'Split Type':

Write-up:About 10-14 days after receiving 2nd dose of HPV vaccine patient complained of double vision, numbness in hands & feet, tremors, abdominal pain, heaviness in arms, fatigue. She was seen by doctor Dx-sixth nerve palsy, abnormal MRI, admitted to hospital."7/14/08-PCP note seen in office 6/2/08-for C/O double vision, 15 days prior seen by ophthamologist. 8/6/08-records received for DOS 6/10-6/13/08-DC DX: ADEM. Presented with diplopia a few weeks prior to admission, seen by optometrist and diagnosed with 6


Changed on 12/8/2009

VAERS ID: 316760 Before After
Age:14.0
Gender:Female
Location:Florida
Vaccinated:2008-05-05
Onset:2008-05-16
Submitted:2008-06-20
Entered:2008-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (NO BRAND NAME) HEP A (HAVRIX) / UNKNOWN MANUFACTURER GLAXOSMITHKLINE BIOLOGICALS - AHAVB222AA / - UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - 1448U / 1 UN / UN

Administered by: Private      Purchased by: Unknown Other
Symptoms: Abdominal pain, CSF oligoclonal band present, Diplopia, Fatigue, Hypoaesthesia, Lumbar puncture, Nuclear magnetic resonance imaging abnormal, Paraesthesia, Sensation of heaviness, Tremor, VIth nerve paralysis, Leukoencephalomyelitis, Epstein-Barr virus antibody positive, Nerve injury, Albumin CSF increased, Blood test

Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: dizziness, sight, numbness
Preexisting Conditions: none
Diagnostic Lab Data: MRI; lumbar puncture; blood 2nd dose; diagnosed with ADEM 8/6/08-records received for DOS 6/10-6/13/08-DC DX: ADEM. CSF albumin increased 5120, olig bands increased 11. EBV VCA IGG positive. MRI abnormal .with left periventricular white ma
CDC 'Split Type':

Write-up:About 10-14 days after receiving 2nd dose of HPV vaccine patient complained of double vision, numbness in hands & feet, tremors, abdominal pain, heaviness in arms, fatigue. She was seen by doctor Dx-sixth nerve palsy, abnormal MRI, admitted to hospital."7/14/08-PCP hospital. 7/14/08-PCP note seen in office 6/2/08-for C/O double vision, 15 days prior seen by ophthamologist. 8/6/08-records received for DOS 6/10-6/13/08-DC DX: ADEM. Presented with diplopia a few weeks prior to admission, seen by optometrist and diagnosed with 6 6th nerve palsy. Two weeks prior to admission presented with paresthesias involving all extremities. Diplopia somewhat improved.


Changed on 4/14/2017

VAERS ID: 316760 Before After
Age:14.0
Gender:Female
Location:Florida
Vaccinated:2008-05-05
Onset:2008-05-16
Submitted:2008-06-20
Entered:2008-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB222AA / - UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1448U / 1 UN / UN

Administered by: Private      Purchased by: Other
Symptoms: Abdominal pain, CSF oligoclonal band present, Diplopia, Fatigue, Hypoaesthesia, Lumbar puncture, Nuclear magnetic resonance imaging abnormal, Paraesthesia, Sensation of heaviness, Tremor, VIth nerve paralysis, Leukoencephalomyelitis, Epstein-Barr virus antibody positive, Nerve injury, Albumin CSF increased, Blood test

Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: dizziness, sight, numbness
Preexisting Conditions: none
Diagnostic Lab Data: MRI; lumbar puncture; blood 2nd dose; diagnosed with ADEM 8/6/08-records received for DOS 6/10-6/13/08-DC DX: ADEM. CSF albumin increased 5120, olig bands increased 11. EBV VCA IGG positive. MRI abnormal .with left periventricular white ma matter lesion. MRI spine normal.
CDC 'Split Type':

Write-up:About 10-14 days after receiving 2nd dose of HPV vaccine patient complained of double vision, numbness in hands & feet, tremors, abdominal pain, heaviness in arms, fatigue. She was seen by doctor Dx-sixth nerve palsy, abnormal MRI, admitted to hospital. 7/14/08-PCP note seen in office 6/2/08-for C/O double vision, 15 days prior seen by ophthamologist. 8/6/08-records received for DOS 6/10-6/13/08-DC DX: ADEM. Presented with diplopia a few weeks prior to admission, seen by optometrist and diagnosed with 6th nerve palsy. Two weeks prior to admission presented with paresthesias involving all extremities. Diplopia somewhat improved.


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