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This is VAERS ID 350817

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 350817
Age:12.0
Gender:Female
Location:New Jersey
Vaccinated:2008-06-20
Onset:2009-06-20
Submitted:2009-06-23
Entered:2009-07-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0067X / 0 LA / UN
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U2638AA / 0 UN / UN
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2404AA / 0 UN / UN

Administered by: Private      Purchased by: Private
Symptoms: Blood lactic acid increased, Dystonia, Encephalopathy, Expressive language disorder, Hemiparesis, Injection site erythema, Injection site induration, Pancreatitis, Pharyngitis, Gastrointestinal tube insertion, Injection site swelling, Cardiac operation, Metabolic function test abnormal, Brain injury

Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Hole in heart
Preexisting Conditions: ASD
Diagnostic Lab Data: Lost all metabolic ability.
CDC 'Split Type':

Write-up:GARDASIL. Redness, swelling area hard around vaccine. Had open heart surgery 6/27/09. Suffered brain injury. Lactic acids raised to brain, abnormal white matter. 7/13/2009 MR received from PCP 6/20-/2009. In for WCC on 6/20/09. For surgical repair of ASD in 1 week. Impression: Healthy. ASD. Returned 6/23/09 to have throat checked. Impression: Pharyngitis. In for surgury ~6/27/09 with "catastrophic event" intraoperatively with subsequent encephalopathy. ? Mitochondrial defect. Pt currently with L hemiparesis, R dystonia, non-verbal with receptive language intact. S/P pancreatitis with G-tube feeds. Transferred to higher level of care.


Changed on 4/7/2010

VAERS ID: 350817 Before After
Age:12.0
Gender:Female
Location:New Jersey
Vaccinated:2008-06-20
Onset:2009-06-20
Submitted:2009-06-23
Entered:2009-07-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0067X / 0 LA / UN
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2638AA / 0 UN / UN
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2404AA / 0 UN / UN

Administered by: Private      Purchased by: Private
Symptoms: Blood lactic acid increased, Dystonia, Encephalopathy, Expressive language disorder, Hemiparesis, Injection site erythema, Injection site induration, Pancreatitis, Pharyngitis, Gastrointestinal tube insertion, Injection site swelling, Cardiac operation, Metabolic function test abnormal, Brain injury

Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Hole in heart
Preexisting Conditions: ASD
Diagnostic Lab Data: Lost all metabolic ability.
CDC 'Split Type':

Write-up:GARDASIL. Redness, swelling area hard around vaccine. Had open heart surgery 6/27/09. Suffered brain injury. Lactic acids raised to brain, abnormal white matter. 7/13/2009 MR received from PCP 6/20-/2009. In for WCC on 6/20/09. For surgical repair of ASD in 1 week. Impression: Healthy. ASD. Returned 6/23/09 to have throat checked. Impression: Pharyngitis. In for surgury ~6/27/09 with "catastrophic event" intraoperatively with subsequent encephalopathy. ? Mitochondrial defect. Pt currently with L hemiparesis, R dystonia, non-verbal with receptive language intact. S/P pancreatitis with G-tube feeds. Transferred to higher level of care.


Changed on 4/14/2017

VAERS ID: 350817 Before After
Age:12.0
Gender:Female
Location:New Jersey
Vaccinated:2008-06-20
Onset:2009-06-20
Submitted:2009-06-23
Entered:2009-07-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0067X / 0 LA / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2638AA / 0 UN / UN
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2404AA / 0 UN / UN

Administered by: Private      Purchased by: Private
Symptoms: Blood lactic acid increased, Dystonia, Encephalopathy, Expressive language disorder, Hemiparesis, Injection site erythema, Injection site induration, Pancreatitis, Pharyngitis, Gastrointestinal tube insertion, Injection site swelling, Cardiac operation, Metabolic function test abnormal, Brain injury

Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Hole in heart
Preexisting Conditions: ASD
Diagnostic Lab Data: Lost all metabolic ability.
CDC 'Split Type':

Write-up:GARDASIL. Redness, swelling area hard around vaccine. Had open heart surgery 6/27/09. Suffered brain injury. Lactic acids raised to brain, abnormal white matter. 7/13/2009 MR received from PCP 6/20-/2009. In for WCC on 6/20/09. For surgical repair of ASD in 1 week. Impression: Healthy. ASD. Returned 6/23/09 to have throat checked. Impression: Pharyngitis. In for surgury ~6/27/09 with "catastrophic event" intraoperatively with subsequent encephalopathy. ? Mitochondrial defect. Pt currently with L hemiparesis, R dystonia, non-verbal with receptive language intact. S/P pancreatitis with G-tube feeds. Transferred to higher level of care.


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