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This is VAERS ID 341419

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

341419
VAERS Form:
Age:12.0
Gender:Female
Location:New Hampshire
Vaccinated:2008-08-01
Onset:0000-00-00
Submitted:2009-02-12
Entered:2009-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0279X / 0 UN / UN

Administered by: Private      Purchased by: Public
Symptoms: Abdominal pain lower, Acne, Asthenia, Bacteriuria, Blood thyroid stimulating hormone, Chest discomfort, Cough, Disturbance in attention, Dizziness, Dysphonia, Electroencephalogram abnormal, Fall, Full blood count, Headache, Insomnia, Migraine, Muscle rigidity, Muscular weakness, Nasal congestion, Nuclear magnetic resonance imaging, Red blood cells urine positive, Rhinorrhoea, Sensory disturbance, Stress, Syncope, Tunnel vision, Upper respiratory tract infection, Urinary tract infection, Urine abnormality, Visual acuity reduced, Visual impairment, Weight decreased, White blood cells urine positive, Abasia, Urinary sediment present, Urine leukocyte esterase positive, Musculoskeletal stiffness, Protein urine present, Cardiac monitoring, Urine transitional cells present, Blood test, Metabolic function test, Vaccine positive rechallenge, Oropharyngeal pain

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: None 5/18/09 medical records received DOS 12/1/08 to 4/8/09. benzaclin, albuterol, Pediazole
Current Illness: None
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data: MRI; EEG; Heart monitor; Blood work. 5/18/09 hospital records received DOS 3/5/09 to 3/6/09. LABS and DIAGNOSTICS: Urinalysis - hazy, protein trace, leukocyte esterase, WBC 2, RBC 1, bacteria moderate, squamous epithelial cells 5, tr
CDC 'Split Type':

Write-up:8/1/08- 1st shot- fainting began, headaches. 10/2/08-2nd shot- fainting + headaches continue inability to sleep or concentrate, inability to see or have use of her legs during fainting, sensitive nerves. 5/18/09 hospital records received DOS 3/5/09 to 3/6/09. FINAL DIAGNOSIS: Migraine - non-classic type, urinary tract infection Post vaccination: light headedness, feels that she will fall over, floating in lower extremities, and tunnel vision. Later insomnia, syncope on standing, fell backwards with stiffening in legs. 4/5 strenght L upper extremity. Urinary tract infection. 5/18/09 medical records received - includes neuro consult - DOS 12/1/08 to 4/8/09. FINAL DIAGNOSIS: Seizures presented as syncope Post vaccination: with change of position sees dark spots. Fell backwards with episode of rigidity. Weight loss, lower abdominal pain. Acne forehead, cheeks, chin, chest. URI with cough, congestion, rhinorrhea, hoarse, sore throat, chest heavy, difficulty taking deep breaths. Neurology consult - headaches, stress, people picking on me,


Changed on 7/31/2010

341419 Before After
VAERS Form:
Age:12.0
Gender:Female
Location:New Hampshire
Vaccinated:2008-08-01
Onset:0000-00-00
Submitted:2009-02-12
Entered:2009-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0279X / 0 UN / UN

Administered by: Private      Purchased by: Public
Symptoms: Abdominal pain lower, Acne, Asthenia, Bacteriuria, Blood thyroid stimulating hormone, Chest discomfort, Cough, Disturbance in attention, Dizziness, Dysphonia, Electroencephalogram abnormal, Fall, Full blood count, Headache, Insomnia, Migraine, Muscle rigidity, Muscular weakness, Nasal congestion, Nuclear magnetic resonance imaging, Red blood cells urine positive, Rhinorrhoea, Sensory disturbance, Stress, Syncope, Tunnel vision, Upper respiratory tract infection, Urinary tract infection, Urine abnormality, Visual acuity reduced, Visual impairment, Weight decreased, White blood cells urine positive, Abasia, Urinary sediment present, Urine leukocyte esterase positive, Musculoskeletal stiffness, Protein urine present, Cardiac monitoring, Urine transitional cells present, Blood test, Metabolic function test, Vaccine positive rechallenge, Oropharyngeal pain

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: None 5/18/09 medical records received DOS 12/1/08 to 4/8/09. benzaclin, albuterol, Pediazole
Current Illness: None
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data: MRI; EEG; Heart monitor; Blood work. 5/18/09 hospital records received DOS 3/5/09 to 3/6/09. LABS and DIAGNOSTICS: Urinalysis - hazy, protein trace, leukocyte esterase, WBC 2, RBC 1, bacteria moderate, squamous epithelial cells 5, tr
CDC 'Split Type':

Write-up:8/1/08- 1st shot- fainting began, headaches. 10/2/08-2nd shot- fainting + headaches continue inability to sleep or concentrate, inability to see or have use of her legs during fainting, sensitive nerves. 5/18/09 hospital records received DOS 3/5/09 to 3/6/09. FINAL DIAGNOSIS: Migraine - non-classic type, urinary tract infection Post vaccination: light headedness, feels that she will fall over, floating in lower extremities, and tunnel vision. Later insomnia, syncope on standing, fell backwards with stiffening in legs. 4/5 strenght L upper extremity. Urinary tract infection. 5/18/09 medical records received - includes neuro consult - DOS 12/1/08 to 4/8/09. FINAL DIAGNOSIS: Seizures presented as syncope Post vaccination: with change of position sees dark spots. Fell backwards with episode of rigidity. Weight loss, lower abdominal pain. Acne forehead, cheeks, chin, chest. URI with cough, congestion, rhinorrhea, hoarse, sore throat, chest heavy, difficulty taking deep breaths. Neurology consult - headaches, stress, people picking on me,


Changed on 8/31/2010

341419 Before After
VAERS Form:
Age:12.0
Gender:Female
Location:New Hampshire
Vaccinated:2008-08-01
Onset:0000-00-00
Submitted:2009-02-12
Entered:2009-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0279X / 0 UN / UN

Administered by: Private      Purchased by: Public
Symptoms: Bacteriuria, Chest discomfort, Disturbance in attention, Gait disturbance, Headache, Insomnia, Nuclear magnetic resonance imaging, Syncope, Urine abnormality, Visual acuity reduced, Abasia, Urinary sediment present, Cardiac monitoring, Blood test, Vaccine positive rechallenge

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: None 5/18/09 medical records received DOS 12/1/08 to 4/8/09. benzaclin, albuterol, Pediazole
Current Illness: None
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data: MRI; EEG; Heart monitor; Blood work. 5/18/09 hospital records received DOS 3/5/09 to 3/6/09. LABS and DIAGNOSTICS: Urinalysis - hazy, protein trace, leukocyte esterase, WBC 2, RBC 1, bacteria moderate, squamous epithelial cells 5, tr
CDC 'Split Type':

Write-up:8/1/08- 1st shot- fainting began, headaches. 10/2/08-2nd shot- fainting + headaches continue inability to sleep or concentrate, inability to see or have use of her legs during fainting, sensitive nerves. 5/18/09 hospital records received DOS 3/5/09 to 3/6/09. FINAL DIAGNOSIS: Migraine - non-classic type, urinary tract infection Post vaccination: light headedness, feels that she will fall over, floating in lower extremities, and tunnel vision. Later insomnia, syncope on standing, fell backwards with stiffening in legs. 4/5 strenght L upper extremity. Urinary tract infection. 5/18/09 medical records received - includes neuro consult - DOS 12/1/08 to 4/8/09. FINAL DIAGNOSIS: Seizures presented as syncope Post vaccination: with change of position sees dark spots. Fell backwards with episode of rigidity. Weight loss, lower abdominal pain. Acne forehead, cheeks, chin, chest. URI with cough, congestion, rhinorrhea, hoarse, sore throat, chest heavy, difficulty taking deep breaths. Neurology consult - headaches, stress, people picking on me,


Changed on 1/4/2011

341419 Before After
VAERS Form:
Age:12.0
Gender:Female
Location:New Hampshire
Vaccinated:2008-08-01
Onset:0000-00-00
Submitted:2009-02-12
Entered:2009-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0279X / 0 UN / UN

Administered by: Private      Purchased by: Public
Symptoms: Bacteriuria, Chest discomfort, Disturbance in attention, Gait disturbance, Headache, Insomnia, Nuclear magnetic resonance imaging, Syncope, Urine abnormality, Visual acuity reduced, Abasia, Urinary sediment present, Cardiac monitoring, Blood test, Vaccine positive rechallenge

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: None 5/18/09 medical records received DOS 12/1/08 to 4/8/09. benzaclin, albuterol, Pediazole
Current Illness: None
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data: MRI; EEG; Heart monitor; Blood work. 5/18/09 hospital records received DOS 3/5/09 to 3/6/09. LABS and DIAGNOSTICS: Urinalysis - hazy, protein trace, leukocyte esterase, WBC 2, RBC 1, bacteria moderate, squamous epithelial cells 5, tr transitional epithelial cells <1. EEG normal. EKG NSR. MRI brain normal. 5/18/09 medical records received - includes neuro consult - DOS 12/1/08 to 4/8/09. LABS and DIAGNOSTICS: EEG - generalized spike and slow wave activity. EKG WNL. Holter Monitor WNL. MRI WNL. CBC WNL. Metabolic profile WNL. TSH WNL.
CDC 'Split Type':

Write-up:8/1/08- 1st shot- fainting began, headaches. 10/2/08-2nd shot- fainting + headaches continue inability to sleep or concentrate, inability to see or have use of her legs during fainting, sensitive nerves. 5/18/09 hospital records received DOS 3/5/09 to 3/6/09. FINAL DIAGNOSIS: Migraine - non-classic type, urinary tract infection Post vaccination: light headedness, feels that she will fall over, floating in lower extremities, and tunnel vision. Later insomnia, syncope on standing, fell backwards with stiffening in legs. 4/5 strenght L upper extremity. Urinary tract infection. 5/18/09 medical records received - includes neuro consult - DOS 12/1/08 to 4/8/09. FINAL DIAGNOSIS: Seizures presented as syncope Post vaccination: with change of position sees dark spots. Fell backwards with episode of rigidity. Weight loss, lower abdominal pain. Acne forehead, cheeks, chin, chest. URI with cough, congestion, rhinorrhea, hoarse, sore throat, chest heavy, difficulty taking deep breaths. Neurology consult - headaches, stress, people picking on me,


Changed on 4/13/2011

341419 Before After
VAERS Form:
Age:12.0
Gender:Female
Location:New Hampshire
Vaccinated:2008-08-01
Onset:0000-00-00
Submitted:2009-02-12
Entered:2009-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0279X / 0 UN / UN

Administered by: Private      Purchased by: Public
Symptoms: Abdominal pain lower, Acne, Asthenia, Bacteriuria, Blood thyroid stimulating hormone, Chest discomfort, Cough, Disturbance in attention, Dizziness, Dysphonia, Electroencephalogram abnormal, Fall, Full blood count, Headache, Insomnia, Migraine, Muscle rigidity, Muscular weakness, Nasal congestion, Nuclear magnetic resonance imaging, Red blood cells urine positive, Rhinorrhoea, Sensory disturbance, Stress, Syncope, Tunnel vision, Upper respiratory tract infection, Urinary tract infection, Urine abnormality, Visual acuity reduced, Visual impairment, Weight decreased, White blood cells urine positive, Abasia, Urinary sediment present, Urine leukocyte esterase positive, Musculoskeletal stiffness, Protein urine present, Cardiac monitoring, Urine transitional cells present, Blood test, Metabolic function test, Vaccine positive rechallenge, Oropharyngeal pain

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: None 5/18/09 medical records received DOS 12/1/08 to 4/8/09. benzaclin, albuterol, Pediazole
Current Illness: None
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data: MRI; EEG; Heart monitor; Blood work. 5/18/09 hospital records received DOS 3/5/09 to 3/6/09. LABS and DIAGNOSTICS: Urinalysis - hazy, protein trace, leukocyte esterase, WBC 2, RBC 1, bacteria moderate, squamous epithelial cells 5, transitional epithelial cells <1. EEG normal. EKG NSR. MRI brain normal. 5/18/09 medical records received - includes neuro consult - DOS 12/1/08 to 4/8/09. LABS and DIAGNOSTICS: EEG - generalized spike and slow wave activity. EKG WNL. Holter Monitor WNL. MRI WNL. CBC WNL. Metabolic profile WNL. TSH WNL.
CDC 'Split Type':

Write-up:8/1/08- 1st shot- fainting began, headaches. 10/2/08-2nd shot- fainting + headaches continue inability to sleep or concentrate, inability to see or have use of her legs during fainting, sensitive nerves. 5/18/09 hospital records received DOS 3/5/09 to 3/6/09. FINAL DIAGNOSIS: Migraine - non-classic type, urinary tract infection Post vaccination: light headedness, feels that she will fall over, floating in lower extremities, and tunnel vision. Later insomnia, syncope on standing, fell backwards with stiffening in legs. 4/5 strenght L upper extremity. Urinary tract infection. 5/18/09 medical records received - includes neuro consult - DOS 12/1/08 to 4/8/09. FINAL DIAGNOSIS: Seizures presented as syncope Post vaccination: with change of position sees dark spots. Fell backwards with episode of rigidity. Weight loss, lower abdominal pain. Acne forehead, cheeks, chin, chest. URI with cough, congestion, rhinorrhea, hoarse, sore throat, chest heavy, difficulty taking deep breaths. Neurology consult - headaches, stress, people picking on me,


Changed on 5/13/2011

341419 Before After
VAERS Form:
Age:12.0
Gender:Female
Location:New Hampshire
Vaccinated:2008-08-01
Onset:0000-00-00
Submitted:2009-02-12
Entered:2009-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0279X / 0 UN / UN

Administered by: Private      Purchased by: Public
Symptoms: Abdominal pain lower, Acne, Asthenia, Bacteriuria, Blood thyroid stimulating hormone, Chest discomfort, Cough, Disturbance in attention, Dizziness, Dysphonia, Electroencephalogram abnormal, Fall, Full blood count, Headache, Insomnia, Migraine, Muscle rigidity, Muscular weakness, Nasal congestion, Nuclear magnetic resonance imaging, Red blood cells urine positive, Rhinorrhoea, Sensory disturbance, Stress, Syncope, Tunnel vision, Upper respiratory tract infection, Urinary tract infection, Urine abnormality, Visual acuity reduced, Visual impairment, Weight decreased, White blood cells urine positive, Abasia, Urinary sediment present, Urine leukocyte esterase positive, Musculoskeletal stiffness, Protein urine present, Cardiac monitoring, Urine transitional cells present, Blood test, Metabolic function test, Vaccine positive rechallenge, Oropharyngeal pain

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: None 5/18/09 medical records received DOS 12/1/08 to 4/8/09. benzaclin, albuterol, Pediazole
Current Illness: None
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data: MRI; EEG; Heart monitor; Blood work. 5/18/09 hospital records received DOS 3/5/09 to 3/6/09. LABS and DIAGNOSTICS: Urinalysis - hazy, protein trace, leukocyte esterase, WBC 2, RBC 1, bacteria moderate, squamous epithelial cells 5, transitional epithelial cells <1. EEG normal. EKG NSR. MRI brain normal. 5/18/09 medical records received - includes neuro consult - DOS 12/1/08 to 4/8/09. LABS and DIAGNOSTICS: EEG - generalized spike and slow wave activity. EKG WNL. Holter Monitor WNL. MRI WNL. CBC WNL. Metabolic profile WNL. TSH WNL.
CDC 'Split Type':

Write-up:8/1/08- 1st shot- fainting began, headaches. 10/2/08-2nd shot- fainting + headaches continue inability to sleep or concentrate, inability to see or have use of her legs during fainting, sensitive nerves. 5/18/09 hospital records received DOS 3/5/09 to 3/6/09. FINAL DIAGNOSIS: Migraine - non-classic type, urinary tract infection Post vaccination: light headedness, feels that she will fall over, floating in lower extremities, and tunnel vision. Later insomnia, syncope on standing, fell backwards with stiffening in legs. 4/5 strenght L upper extremity. Urinary tract infection. 5/18/09 medical records received - includes neuro consult - DOS 12/1/08 to 4/8/09. FINAL DIAGNOSIS: Seizures presented as syncope Post vaccination: with change of position sees dark spots. Fell backwards with episode of rigidity. Weight loss, lower abdominal pain. Acne forehead, cheeks, chin, chest. URI with cough, congestion, rhinorrhea, hoarse, sore throat, chest heavy, difficulty taking deep breaths. Neurology consult - headaches, stress, people picking on me,


Changed on 6/11/2011

341419 Before After
VAERS Form:
Age:12.0
Gender:Female
Location:New Hampshire
Vaccinated:2008-08-01
Onset:0000-00-00
Submitted:2009-02-12
Entered:2009-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0279X / 0 UN / UN

Administered by: Private      Purchased by: Public
Symptoms: Abdominal pain lower, Acne, Asthenia, Bacteriuria, Blood thyroid stimulating hormone, Chest discomfort, Cough, Disturbance in attention, Dizziness, Dysphonia, Electroencephalogram abnormal, Fall, Full blood count, Headache, Insomnia, Migraine, Muscle rigidity, Muscular weakness, Nasal congestion, Nuclear magnetic resonance imaging, Red blood cells urine positive, Rhinorrhoea, Sensory disturbance, Stress, Syncope, Tunnel vision, Upper respiratory tract infection, Urinary tract infection, Urine abnormality, Visual acuity reduced, Visual impairment, Weight decreased, White blood cells urine positive, Abasia, Urinary sediment present, Urine leukocyte esterase positive, Musculoskeletal stiffness, Protein urine present, Cardiac monitoring, Urine transitional cells present, Blood test, Metabolic function test, Vaccine positive rechallenge, Oropharyngeal pain

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: None 5/18/09 medical records received DOS 12/1/08 to 4/8/09. benzaclin, albuterol, Pediazole
Current Illness: None
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data: MRI; EEG; Heart monitor; Blood work. 5/18/09 hospital records received DOS 3/5/09 to 3/6/09. LABS and DIAGNOSTICS: Urinalysis - hazy, protein trace, leukocyte esterase, WBC 2, RBC 1, bacteria moderate, squamous epithelial cells 5, transitional epithelial cells <1. EEG normal. EKG NSR. MRI brain normal. 5/18/09 medical records received - includes neuro consult - DOS 12/1/08 to 4/8/09. LABS and DIAGNOSTICS: EEG - generalized spike and slow wave activity. EKG WNL. Holter Monitor WNL. MRI WNL. CBC WNL. Metabolic profile WNL. TSH WNL.
CDC 'Split Type':

Write-up:8/1/08- 1st shot- fainting began, headaches. 10/2/08-2nd shot- fainting + headaches continue inability to sleep or concentrate, inability to see or have use of her legs during fainting, sensitive nerves. 5/18/09 hospital records received DOS 3/5/09 to 3/6/09. FINAL DIAGNOSIS: Migraine - non-classic type, urinary tract infection Post vaccination: light headedness, feels that she will fall over, floating in lower extremities, and tunnel vision. Later insomnia, syncope on standing, fell backwards with stiffening in legs. 4/5 strenght L upper extremity. Urinary tract infection. 5/18/09 medical records received - includes neuro consult - DOS 12/1/08 to 4/8/09. FINAL DIAGNOSIS: Seizures presented as syncope Post vaccination: with change of position sees dark spots. Fell backwards with episode of rigidity. Weight loss, lower abdominal pain. Acne forehead, cheeks, chin, chest. URI with cough, congestion, rhinorrhea, hoarse, sore throat, chest heavy, difficulty taking deep breaths. Neurology consult - headaches, stress, people picking on me,


Changed on 6/14/2014

341419 Before After
VAERS Form:
Age:12.0
Gender:Female
Location:New Hampshire
Vaccinated:2008-08-01
Onset:0000-00-00
Submitted:2009-02-12
Entered:2009-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0279X / 0 UN / UN

Administered by: Private      Purchased by: Public
Symptoms: Abdominal pain lower, Acne, Asthenia, Bacteriuria, Blood thyroid stimulating hormone, Chest discomfort, Cough, Disturbance in attention, Dizziness, Dysphonia, Electroencephalogram abnormal, Fall, Full blood count, Headache, Insomnia, Migraine, Muscle rigidity, Muscular weakness, Nasal congestion, Nuclear magnetic resonance imaging, Red blood cells urine positive, Rhinorrhoea, Sensory disturbance, Stress, Syncope, Tunnel vision, Upper respiratory tract infection, Urinary tract infection, Urine abnormality, Visual acuity reduced, Visual impairment, Weight decreased, White blood cells urine positive, Abasia, Urinary sediment present, Urine leukocyte esterase positive, Musculoskeletal stiffness, Protein urine present, Cardiac monitoring, Urine transitional cells present, Blood test, Metabolic function test, Vaccine positive rechallenge, Oropharyngeal pain

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: None 5/18/09 medical records received DOS 12/1/08 to 4/8/09. benzaclin, albuterol, Pediazole
Current Illness: None
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data: MRI; EEG; Heart monitor; Blood work. 5/18/09 hospital records received DOS 3/5/09 to 3/6/09. LABS and DIAGNOSTICS: Urinalysis - hazy, protein trace, leukocyte esterase, WBC 2, RBC 1, bacteria moderate, squamous epithelial cells 5, transitional epithelial cells <1. EEG normal. EKG NSR. MRI brain normal. 5/18/09 medical records received - includes neuro consult - DOS 12/1/08 to 4/8/09. LABS and DIAGNOSTICS: EEG - generalized spike and slow wave activity. EKG WNL. Holter Monitor WNL. MRI WNL. CBC WNL. Metabolic profile WNL. TSH WNL.
CDC 'Split Type':

Write-up:8/1/08- 1st shot- fainting began, headaches. 10/2/08-2nd shot- fainting + headaches continue inability to sleep or concentrate, inability to see or have use of her legs during fainting, sensitive nerves. 5/18/09 hospital records received DOS 3/5/09 to 3/6/09. FINAL DIAGNOSIS: Migraine - non-classic type, urinary tract infection Post vaccination: light headedness, feels that she will fall over, floating in lower extremities, and tunnel vision. Later insomnia, syncope on standing, fell backwards with stiffening in legs. 4/5 strenght L upper extremity. Urinary tract infection. 5/18/09 medical records received - includes neuro consult - DOS 12/1/08 to 4/8/09. FINAL DIAGNOSIS: Seizures presented as syncope Post vaccination: with change of position sees dark spots. Fell backwards with episode of rigidity. Weight loss, lower abdominal pain. Acne forehead, cheeks, chin, chest. URI with cough, congestion, rhinorrhea, hoarse, sore throat, chest heavy, difficulty taking deep breaths. Neurology consult - headaches, stress, people picking on me,


Changed on 4/14/2017

341419 Before After
VAERS Form:
Age:12.0
Gender:Female
Location:New Hampshire
Vaccinated:2008-08-01
Onset:0000-00-00
Submitted:2009-02-12
Entered:2009-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0279X / 0 UN / UN

Administered by: Private      Purchased by: Public
Symptoms: Abdominal pain lower, Acne, Asthenia, Bacteriuria, Blood thyroid stimulating hormone, Chest discomfort, Cough, Disturbance in attention, Dizziness, Dysphonia, Electroencephalogram abnormal, Fall, Full blood count, Headache, Insomnia, Migraine, Muscle rigidity, Muscular weakness, Nasal congestion, Nuclear magnetic resonance imaging, Red blood cells urine positive, Rhinorrhoea, Sensory disturbance, Stress, Syncope, Tunnel vision, Upper respiratory tract infection, Urinary tract infection, Urine abnormality, Visual acuity reduced, Visual impairment, Weight decreased, White blood cells urine positive, Abasia, Urinary sediment present, Urine leukocyte esterase positive, Musculoskeletal stiffness, Protein urine present, Cardiac monitoring, Urine transitional cells present, Blood test, Metabolic function test, Vaccine positive rechallenge, Oropharyngeal pain

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: None 5/18/09 medical records received DOS 12/1/08 to 4/8/09. benzaclin, albuterol, Pediazole
Current Illness: None
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data: MRI; EEG; Heart monitor; Blood work. 5/18/09 hospital records received DOS 3/5/09 to 3/6/09. LABS and DIAGNOSTICS: Urinalysis - hazy, protein trace, leukocyte esterase, WBC 2, RBC 1, bacteria moderate, squamous epithelial cells 5, transitional epithelial cells <1. EEG normal. EKG NSR. MRI brain normal. 5/18/09 medical records received - includes neuro consult - DOS 12/1/08 to 4/8/09. LABS and DIAGNOSTICS: EEG - generalized spike and slow wave activity. EKG WNL. Holter Monitor WNL. MRI WNL. CBC WNL. Metabolic profile WNL. TSH WNL.
CDC 'Split Type':

Write-up:8/1/08- 1st shot- fainting began, headaches. 10/2/08-2nd shot- fainting + headaches continue inability to sleep or concentrate, inability to see or have use of her legs during fainting, sensitive nerves. 5/18/09 hospital records received DOS 3/5/09 to 3/6/09. FINAL DIAGNOSIS: Migraine - non-classic type, urinary tract infection Post vaccination: light headedness, feels that she will fall over, floating in lower extremities, and tunnel vision. Later insomnia, syncope on standing, fell backwards with stiffening in legs. 4/5 strenght L upper extremity. Urinary tract infection. 5/18/09 medical records received - includes neuro consult - DOS 12/1/08 to 4/8/09. FINAL DIAGNOSIS: Seizures presented as syncope Post vaccination: with change of position sees dark spots. Fell backwards with episode of rigidity. Weight loss, lower abdominal pain. Acne forehead, cheeks, chin, chest. URI with cough, congestion, rhinorrhea, hoarse, sore throat, chest heavy, difficulty taking deep breaths. Neurology consult - headaches, stress, people picking on me,


Changed on 9/14/2017

341419 Before After
VAERS Form:(blank) 1
Age:12.0
Gender:Female
Location:New Hampshire
Vaccinated:2008-08-01
Onset:0000-00-00
Submitted:2009-02-12
Entered:2009-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0279X / 0 1 UN / UN

Administered by: Private      Purchased by: Public
Symptoms: Disturbance in attention, Headache, Insomnia, Nuclear magnetic resonance imaging, Syncope, Visual acuity reduced, Abasia, Cardiac monitoring, Blood test, Vaccine positive rechallenge

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: None 5/18/09 medical records received DOS 12/1/08 to 4/8/09. benzaclin, albuterol, Pediazole
Current Illness: None
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data: MRI; EEG; Heart monitor; Blood work. 5/18/09 hospital records received DOS 3/5/09 to 3/6/09. LABS and DIAGNOSTICS: Urinalysis - hazy, protein trace, leukocyte esterase, WBC 2, RBC 1, bacteria moderate, squamous epithelial cells 5, transitional epithelial cells <1. EEG normal. EKG NSR. MRI brain normal. 5/18/09 medical records received - includes neuro consult - DOS 12/1/08 to 4/8/09. LABS and DIAGNOSTICS: EEG - generalized spike and slow wave activity. EKG WNL. Holter Monitor WNL. MRI WNL. CBC WNL. Metabolic profile WNL. TSH WNL.
CDC 'Split Type':

Write-up:8/1/08- 1st shot- fainting began, headaches. 10/2/08-2nd shot- fainting + headaches continue inability to sleep or concentrate, inability to see or have use of her legs during fainting, sensitive nerves. 5/18/09 hospital records received DOS 3/5/09 to 3/6/09. FINAL DIAGNOSIS: Migraine - non-classic type, urinary tract infection Post vaccination: light headedness, feels that she will fall over, floating in lower extremities, and tunnel vision. Later insomnia, syncope on standing, fell backwards with stiffening in legs. 4/5 strenght L upper extremity. Urinary tract infection. 5/18/09 medical records received - includes neuro consult - DOS 12/1/08 to 4/8/09. FINAL DIAGNOSIS: Seizures presented as syncope Post vaccination: with change of position sees dark spots. Fell backwards with episode of rigidity. Weight loss, lower abdominal pain. Acne forehead, cheeks, chin, chest. URI with cough, congestion, rhinorrhea, hoarse, sore throat, chest heavy, difficulty taking deep breaths. Neurology consult - headaches, stress, people picking on me,


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