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This is VAERS ID 358271

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

358271
VAERS Form:
Age:14.0
Gender:Female
Location:California
Vaccinated:2009-08-18
Onset:2009-08-19
Submitted:2009-09-24
Entered:2009-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0670Y / 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Antinuclear antibody, Audiogram abnormal, Cyst, Deafness neurosensory, Dizziness, Headache, Nausea, Nuclear magnetic resonance imaging abnormal, Tinnitus, Red blood cell sedimentation rate, Ear discomfort, Laboratory test normal, Steroid therapy, Metabolic function test

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:
Current Illness: none
Preexisting Conditions: none. 9/28/09 ENT Consultant records DOS 8/24/09. Asthma.
Allergies:
Diagnostic Lab Data: MRI IAC: normal. labs: ESR, ANA SCREEN, COMPREHENSIVE METABOLIC PANAL: pending. 9/28/09 ENT Consultant records DOS 8/24/09 LABS and DIAGNOSTICS: Audiogram - Abnormal. MRI - Abnormal. ANA - Pending. Chem - WNL.
CDC 'Split Type':

Write-up:headache day of injection 8/18, ear discomfort and sudden hearing loss 8/19 to R ear. appointment with PCP 8/20. appt with ENT specialist 8/24, prescribed prednisone. appointment with audiologist 8/24. apointment with ENT specialist and Audiologist 9/8. MRI ordered and done 9/10. appt 9/11 with ENT specialist for steroid injection to R ear. Appt 9/22 with ENT specialist and audiologist. labs ordered. 9/28/09 ENT Consultant records DOS 8/24/09 DOS 8/24/09 to 9/27/09. Assessment: Sensorineural Hearing Loss. Patient c/o decreased hearing (R) ear, dizziness. Profound sensorineural hearing loss (R) ear, normal hearing (L) ear. Tinnitus. Nausea. Left maxillary sinus bone mucous retention cyst 12/30/09 Pediatric Medical records received for DOS 08/24/09, 09/15/09. Telephone request for referral to ENT specialist. On prednisone and will f/u with ENT Impression : viral hearing loss, probably not vaccine related..


Changed on 1/5/2010

358271 Before After
VAERS Form:
Age:14.0
Gender:Female
Location:California
Vaccinated:2009-08-18
Onset:2009-08-19
Submitted:2009-09-24
Entered:2009-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0670Y / 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Antinuclear antibody, Audiogram abnormal, Cyst, Deafness neurosensory, Dizziness, Headache, Nausea, Nuclear magnetic resonance imaging abnormal, Nuclear magnetic resonance imaging normal, Tinnitus, Red blood cell sedimentation rate, Ear discomfort, Laboratory test normal, Steroid therapy, Metabolic function test

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:
Current Illness: none
Preexisting Conditions: none. 9/28/09 ENT Consultant records DOS 8/24/09. Asthma.
Allergies:
Diagnostic Lab Data: MRI IAC: normal. labs: ESR, ANA SCREEN, COMPREHENSIVE METABOLIC PANAL: pending. 9/28/09 ENT Consultant records DOS 8/24/09 LABS and DIAGNOSTICS: Audiogram - Abnormal. MRI - Abnormal. ANA - Pending. Chem - WNL.
CDC 'Split Type':

Write-up:headache day of injection 8/18, ear discomfort and sudden hearing loss 8/19 to R ear. appointment with PCP 8/20. appt with ENT specialist 8/24, prescribed prednisone. appointment with audiologist 8/24. apointment with ENT specialist and Audiologist 9/8. MRI ordered and done 9/10. appt 9/11 with ENT specialist for steroid injection to R ear. Appt 9/22 with ENT specialist and audiologist. labs ordered. 9/28/09 ENT Consultant records DOS 8/24/09 DOS 8/24/09 to 9/27/09. Assessment: Sensorineural Hearing Loss. Patient c/o decreased hearing (R) ear, dizziness. Profound sensorineural hearing loss (R) ear, normal hearing (L) ear. Tinnitus. Nausea. Left maxillary sinus bone mucous retention cyst 12/30/09 Pediatric Medical records received for DOS 08/24/09, 09/15/09. Telephone request for referral to ENT specialist. On prednisone and will f/u with ENT Impression : viral hearing loss, probably not vaccine related..


Changed on 4/13/2011

358271 Before After
VAERS Form:
Age:14.0
Gender:Female
Location:California
Vaccinated:2009-08-18
Onset:2009-08-19
Submitted:2009-09-24
Entered:2009-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0670Y / 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Antinuclear antibody, Audiogram abnormal, Cyst, Deafness neurosensory, Dizziness, Headache, Nausea, Nuclear magnetic resonance imaging abnormal, Nuclear magnetic resonance imaging normal, Tinnitus, Red blood cell sedimentation rate, Red blood cell sedimentation rate normal, Ear discomfort, Laboratory test normal, Metabolic function test

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:
Current Illness: none
Preexisting Conditions: none. 9/28/09 ENT Consultant records DOS 8/24/09. Asthma.
Allergies:
Diagnostic Lab Data: MRI IAC: normal. labs: ESR, ANA SCREEN, COMPREHENSIVE METABOLIC PANAL: pending. 9/28/09 ENT Consultant records DOS 8/24/09 LABS and DIAGNOSTICS: Audiogram - Abnormal. MRI - Abnormal. ANA - Pending. Chem - WNL.
CDC 'Split Type':

Write-up:headache day of injection 8/18, ear discomfort and sudden hearing loss 8/19 to R ear. appointment with PCP 8/20. appt with ENT specialist 8/24, prescribed prednisone. appointment with audiologist 8/24. apointment with ENT specialist and Audiologist 9/8. MRI ordered and done 9/10. appt 9/11 with ENT specialist for steroid injection to R ear. Appt 9/22 with ENT specialist and audiologist. labs ordered. 9/28/09 ENT Consultant records DOS 8/24/09 DOS 8/24/09 to 9/27/09. Assessment: Sensorineural Hearing Loss. Patient c/o decreased hearing (R) ear, dizziness. Profound sensorineural hearing loss (R) ear, normal hearing (L) ear. Tinnitus. Nausea. Left maxillary sinus bone mucous retention cyst 12/30/09 Pediatric Medical records received for DOS 08/24/09, 09/15/09. Telephone request for referral to ENT specialist. On prednisone and will f/u with ENT Impression : viral hearing loss, probably not vaccine related..


Changed on 5/13/2011

358271 Before After
VAERS Form:
Age:14.0
Gender:Female
Location:California
Vaccinated:2009-08-18
Onset:2009-08-19
Submitted:2009-09-24
Entered:2009-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0670Y / 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Antinuclear antibody, Audiogram abnormal, Cyst, Deafness neurosensory, Dizziness, Headache, Nausea, Nuclear magnetic resonance imaging abnormal, Nuclear magnetic resonance imaging normal, Tinnitus, Red blood cell sedimentation rate, Red blood cell sedimentation rate normal, Ear discomfort, Laboratory test normal, Metabolic function test

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:
Current Illness: none
Preexisting Conditions: none. 9/28/09 ENT Consultant records DOS 8/24/09. Asthma.
Allergies:
Diagnostic Lab Data: MRI IAC: normal. labs: ESR, ANA SCREEN, COMPREHENSIVE METABOLIC PANAL: pending. 9/28/09 ENT Consultant records DOS 8/24/09 LABS and DIAGNOSTICS: Audiogram - Abnormal. MRI - Abnormal. ANA - Pending. Chem - WNL.
CDC 'Split Type':

Write-up:headache day of injection 8/18, ear discomfort and sudden hearing loss 8/19 to R ear. appointment with PCP 8/20. appt with ENT specialist 8/24, prescribed prednisone. appointment with audiologist 8/24. apointment with ENT specialist and Audiologist 9/8. MRI ordered and done 9/10. appt 9/11 with ENT specialist for steroid injection to R ear. Appt 9/22 with ENT specialist and audiologist. labs ordered. 9/28/09 ENT Consultant records DOS 8/24/09 DOS 8/24/09 to 9/27/09. Assessment: Sensorineural Hearing Loss. Patient c/o decreased hearing (R) ear, dizziness. Profound sensorineural hearing loss (R) ear, normal hearing (L) ear. Tinnitus. Nausea. Left maxillary sinus bone mucous retention cyst 12/30/09 Pediatric Medical records received for DOS 08/24/09, 09/15/09. Telephone request for referral to ENT specialist. On prednisone and will f/u with ENT Impression : viral hearing loss, probably not vaccine related..


Changed on 6/11/2011

358271 Before After
VAERS Form:
Age:14.0
Gender:Female
Location:California
Vaccinated:2009-08-18
Onset:2009-08-19
Submitted:2009-09-24
Entered:2009-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0670Y / 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Antinuclear antibody, Audiogram abnormal, Cyst, Deafness neurosensory, Dizziness, Headache, Nausea, Nuclear magnetic resonance imaging abnormal, Nuclear magnetic resonance imaging normal, Tinnitus, Red blood cell sedimentation rate, Red blood cell sedimentation rate normal, Ear discomfort, Laboratory test normal, Metabolic function test

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:
Current Illness: none
Preexisting Conditions: none. 9/28/09 ENT Consultant records DOS 8/24/09. Asthma.
Allergies:
Diagnostic Lab Data: MRI IAC: normal. labs: ESR, ANA SCREEN, COMPREHENSIVE METABOLIC PANAL: pending. 9/28/09 ENT Consultant records DOS 8/24/09 LABS and DIAGNOSTICS: Audiogram - Abnormal. MRI - Abnormal. ANA - Pending. Chem - WNL.
CDC 'Split Type':

Write-up:headache day of injection 8/18, ear discomfort and sudden hearing loss 8/19 to R ear. appointment with PCP 8/20. appt with ENT specialist 8/24, prescribed prednisone. appointment with audiologist 8/24. apointment with ENT specialist and Audiologist 9/8. MRI ordered and done 9/10. appt 9/11 with ENT specialist for steroid injection to R ear. Appt 9/22 with ENT specialist and audiologist. labs ordered. 9/28/09 ENT Consultant records DOS 8/24/09 DOS 8/24/09 to 9/27/09. Assessment: Sensorineural Hearing Loss. Patient c/o decreased hearing (R) ear, dizziness. Profound sensorineural hearing loss (R) ear, normal hearing (L) ear. Tinnitus. Nausea. Left maxillary sinus bone mucous retention cyst 12/30/09 Pediatric Medical records received for DOS 08/24/09, 09/15/09. Telephone request for referral to ENT specialist. On prednisone and will f/u with ENT Impression : viral hearing loss, probably not vaccine related..


Changed on 4/14/2017

358271 Before After
VAERS Form:
Age:14.0
Gender:Female
Location:California
Vaccinated:2009-08-18
Onset:2009-08-19
Submitted:2009-09-24
Entered:2009-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0670Y / 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Antinuclear antibody, Audiogram abnormal, Cyst, Deafness neurosensory, Dizziness, Headache, Nausea, Nuclear magnetic resonance imaging abnormal, Nuclear magnetic resonance imaging normal, Tinnitus, Red blood cell sedimentation rate, Red blood cell sedimentation rate normal, Ear discomfort, Laboratory test normal, Metabolic function test

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:
Current Illness: none
Preexisting Conditions: none. 9/28/09 ENT Consultant records DOS 8/24/09. Asthma.
Allergies:
Diagnostic Lab Data: MRI IAC: normal. labs: ESR, ANA SCREEN, COMPREHENSIVE METABOLIC PANAL: pending. 9/28/09 ENT Consultant records DOS 8/24/09 LABS and DIAGNOSTICS: Audiogram - Abnormal. MRI - Abnormal. ANA - Pending. Chem - WNL.
CDC 'Split Type':

Write-up:headache day of injection 8/18, ear discomfort and sudden hearing loss 8/19 to R ear. appointment with PCP 8/20. appt with ENT specialist 8/24, prescribed prednisone. appointment with audiologist 8/24. apointment with ENT specialist and Audiologist 9/8. MRI ordered and done 9/10. appt 9/11 with ENT specialist for steroid injection to R ear. Appt 9/22 with ENT specialist and audiologist. labs ordered. 9/28/09 ENT Consultant records DOS 8/24/09 DOS 8/24/09 to 9/27/09. Assessment: Sensorineural Hearing Loss. Patient c/o decreased hearing (R) ear, dizziness. Profound sensorineural hearing loss (R) ear, normal hearing (L) ear. Tinnitus. Nausea. Left maxillary sinus bone mucous retention cyst 12/30/09 Pediatric Medical records received for DOS 08/24/09, 09/15/09. Telephone request for referral to ENT specialist. On prednisone and will f/u with ENT Impression : viral hearing loss, probably not vaccine related..


Changed on 9/14/2017

358271 Before After
VAERS Form:(blank) 1
Age:14.0
Gender:Female
Location:California
Vaccinated:2009-08-18
Onset:2009-08-19
Submitted:2009-09-24
Entered:2009-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0670Y / 1 2 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Antinuclear antibody, Headache, Nuclear magnetic resonance imaging abnormal, Nuclear magnetic resonance imaging normal, Red blood cell sedimentation rate, Ear discomfort, Metabolic function test

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:
Current Illness: none
Preexisting Conditions: none. 9/28/09 ENT Consultant records DOS 8/24/09. Asthma.
Allergies:
Diagnostic Lab Data: MRI IAC: normal. labs: ESR, ANA SCREEN, COMPREHENSIVE METABOLIC PANAL: pending. 9/28/09 ENT Consultant records DOS 8/24/09 LABS and DIAGNOSTICS: Audiogram - Abnormal. MRI - Abnormal. ANA - Pending. Chem - WNL.
CDC 'Split Type':

Write-up:headache day of injection 8/18, ear discomfort and sudden hearing loss 8/19 to R ear. appointment with PCP 8/20. appt with ENT specialist 8/24, prescribed prednisone. appointment with audiologist 8/24. apointment with ENT specialist and Audiologist 9/8. MRI ordered and done 9/10. appt 9/11 with ENT specialist for steroid injection to R ear. Appt 9/22 with ENT specialist and audiologist. labs ordered. 9/28/09 ENT Consultant records DOS 8/24/09 DOS 8/24/09 to 9/27/09. Assessment: Sensorineural Hearing Loss. Patient c/o decreased hearing (R) ear, dizziness. Profound sensorineural hearing loss (R) ear, normal hearing (L) ear. Tinnitus. Nausea. Left maxillary sinus bone mucous retention cyst 12/30/09 Pediatric Medical records received for DOS 08/24/09, 09/15/09. Telephone request for referral to ENT specialist. On prednisone and will f/u with ENT Impression : viral hearing loss, probably not vaccine related..


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