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This is VAERS ID 371336

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 371336
Age:11.0
Gender:Female
Location:Oklahoma
Vaccinated:2007-03-09
Onset:2008-04-11
Submitted:2009-12-03
Entered:2009-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1426 F / 0 LA / -
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U1878AA / 0 RA / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Antinuclear antibody negative, Lumbar puncture, Nuclear magnetic resonance imaging, Papilloedema, Thyroxine decreased, Ultrasound eye abnormal, Ultrasound scan, Visual acuity reduced, Visual field defect, Visual field tests, Visual impairment, White blood cell count increased, CSF test abnormal, Optic nerve disorder, Antibody test negative, Blood test

Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NO
Preexisting Conditions: NO 12/04/09 PMH: right knee plica; sinusitis; acne; NKDA.
Diagnostic Lab Data: SPINAL TAP, BLOOD WORK, MRI, VISUAL FIELD AND ULTRASOUNDS AND BAYBE OTHERS 12/04/09 Labs/Diagnostics: MRI brain: normal; AB Bartonella: negative; Free T4: 0.73 (L); ANA: not detected; WBC 13.6 (H); CSF culture: rare WBCs; Ultrasound optic
CDC 'Split Type':

Write-up:VISION PROBLEMS, SWOLLEN OPTIC NERVE, PAPILLEDEMA. WENT TO SPECIALISTS AND STARTED TESTING. HAD EYE EXAMS, ULTRASOUNDS OF EYES, SPINAL TAP, MRI, BLOOD WORK AND VISUAL FIELD. POSSIBLE OTHER TEST 12/04/09 Opthalmology records received for DOS 04/11/08-09/19/08. Pt. presents with difficulty with hand work x 1-2 weeks DX: papilledema 12/04/09 Medical records received for DOS 04/11/08, 04/16/08, 04/18/08, 04/29/08 12/04/09 Neuro-opthalmology records received for DOS 06/18/08 DX: visual fields enlarged blind spot, right eye; bilateral optic nerve drusen 12/04/09 PCP records received for DOS 03/09/07-07/10/09.


Changed on 4/7/2010

VAERS ID: 371336 Before After
Age:11.0
Gender:Female
Location:Oklahoma
Vaccinated:2007-03-09
Onset:2008-04-11
Submitted:2009-12-03
Entered:2009-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1426 F / 0 LA / -
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1878AA / 0 RA / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Antinuclear antibody negative, Lumbar puncture, Nuclear magnetic resonance imaging, Papilloedema, Thyroxine decreased, Ultrasound eye abnormal, Ultrasound scan, Visual acuity reduced, Visual field defect, Visual field tests, Visual impairment, White blood cell count increased, CSF test abnormal, Optic nerve disorder, Antibody test negative, Blood test

Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NO
Preexisting Conditions: NO 12/04/09 PMH: right knee plica; sinusitis; acne; NKDA.
Diagnostic Lab Data: SPINAL TAP, BLOOD WORK, MRI, VISUAL FIELD AND ULTRASOUNDS AND BAYBE OTHERS 12/04/09 Labs/Diagnostics: MRI brain: normal; AB Bartonella: negative; Free T4: 0.73 (L); ANA: not detected; WBC 13.6 (H); CSF culture: rare WBCs; Ultrasound optic
CDC 'Split Type':

Write-up:VISION PROBLEMS, SWOLLEN OPTIC NERVE, PAPILLEDEMA. WENT TO SPECIALISTS AND STARTED TESTING. HAD EYE EXAMS, ULTRASOUNDS OF EYES, SPINAL TAP, MRI, BLOOD WORK AND VISUAL FIELD. POSSIBLE OTHER TEST 12/04/09 Opthalmology records received for DOS 04/11/08-09/19/08. Pt. presents with difficulty with hand work x 1-2 weeks DX: papilledema 12/04/09 Medical records received for DOS 04/11/08, 04/16/08, 04/18/08, 04/29/08 12/04/09 Neuro-opthalmology records received for DOS 06/18/08 DX: visual fields enlarged blind spot, right eye; bilateral optic nerve drusen 12/04/09 PCP records received for DOS 03/09/07-07/10/09.


Changed on 1/13/2014

VAERS ID: 371336 Before After
Age:11.0
Gender:Female
Location:Oklahoma
Vaccinated:2007-03-09
Onset:2008-04-11
Submitted:2009-12-03
Entered:2009-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1426 F 1426F / 0 LA / -
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1878AA / 0 RA / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Antinuclear antibody negative, Lumbar puncture, Nuclear magnetic resonance imaging, Papilloedema, Thyroxine decreased, Ultrasound eye abnormal, Ultrasound scan, Visual acuity reduced, Visual field defect, Visual field tests, Visual impairment, White blood cell count increased, CSF test abnormal, Optic nerve disorder, Antibody test negative, Blood test

Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NO
Preexisting Conditions: NO 12/04/09 PMH: right knee plica; sinusitis; acne; NKDA.
Diagnostic Lab Data: SPINAL TAP, BLOOD WORK, MRI, VISUAL FIELD AND ULTRASOUNDS AND BAYBE OTHERS 12/04/09 Labs/Diagnostics: MRI brain: normal; AB Bartonella: negative; Free T4: 0.73 (L); ANA: not detected; WBC 13.6 (H); CSF culture: rare WBCs; Ultrasound optic nerve: orbital echography of right eye showed enlarged optic nerve-sheath diameter with a positive 30 degree test. B-scan showed significant disc elevation; echo of left eye showed mild elevation and normal retrobulbar optic nerve with no evidence of increased subarachnoid fluid.
CDC 'Split Type':

Write-up:VISION PROBLEMS, SWOLLEN OPTIC NERVE, PAPILLEDEMA. WENT TO SPECIALISTS AND STARTED TESTING. HAD EYE EXAMS, ULTRASOUNDS OF EYES, SPINAL TAP, MRI, BLOOD WORK AND VISUAL FIELD. POSSIBLE OTHER TEST 12/04/09 Opthalmology records received for DOS 04/11/08-09/19/08. Pt. presents with difficulty with hand work x 1-2 weeks DX: papilledema 12/04/09 Medical records received for DOS 04/11/08, 04/16/08, 04/18/08, 04/29/08 12/04/09 Neuro-opthalmology records received for DOS 06/18/08 DX: visual fields enlarged blind spot, right eye; bilateral optic nerve drusen 12/04/09 PCP records received for DOS 03/09/07-07/10/09.


Changed on 3/14/2015

VAERS ID: 371336 Before After
Age:11.0
Gender:Female
Location:Oklahoma
Vaccinated:2007-03-09
Onset:2008-04-11
Submitted:2009-12-03
Entered:2009-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1426F / 0 LA / -
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1878AA / 0 RA / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Antinuclear antibody negative, Blindness, Lumbar puncture, Nuclear magnetic resonance imaging, Papilloedema, Thyroxine decreased, Ultrasound eye abnormal, Ultrasound scan, Visual acuity reduced, Visual field defect, Visual field tests, Visual field tests abnormal, Visual impairment, White blood cell count increased, CSF test abnormal, Optic nerve disorder, Antibody test negative, Blood test

Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NO
Preexisting Conditions: NO 12/04/09 PMH: right knee plica; sinusitis; acne; NKDA.
Diagnostic Lab Data: SPINAL TAP, BLOOD WORK, MRI, VISUAL FIELD AND ULTRASOUNDS AND BAYBE OTHERS 12/04/09 Labs/Diagnostics: MRI brain: normal; AB Bartonella: negative; Free T4: 0.73 (L); ANA: not detected; WBC 13.6 (H); CSF culture: rare WBCs; Ultrasound optic nerve: orbital echography of right eye showed enlarged optic nerve-sheath diameter with a positive 30 degree test. B-scan showed significant disc elevation; echo of left eye showed mild elevation and normal retrobulbar optic nerve with no evidence of increased subarachnoid fluid.
CDC 'Split Type':

Write-up:VISION PROBLEMS, SWOLLEN OPTIC NERVE, PAPILLEDEMA. WENT TO SPECIALISTS AND STARTED TESTING. HAD EYE EXAMS, ULTRASOUNDS OF EYES, SPINAL TAP, MRI, BLOOD WORK AND VISUAL FIELD. POSSIBLE OTHER TEST 12/04/09 Opthalmology records received for DOS 04/11/08-09/19/08. Pt. presents with difficulty with hand work x 1-2 weeks DX: papilledema 12/04/09 Medical records received for DOS 04/11/08, 04/16/08, 04/18/08, 04/29/08 12/04/09 Neuro-opthalmology records received for DOS 06/18/08 DX: visual fields enlarged blind spot, right eye; bilateral optic nerve drusen 12/04/09 PCP records received for DOS 03/09/07-07/10/09.


Changed on 4/14/2017

VAERS ID: 371336 Before After
Age:11.0
Gender:Female
Location:Oklahoma
Vaccinated:2007-03-09
Onset:2008-04-11
Submitted:2009-12-03
Entered:2009-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1426F / 0 LA / -
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1878AA / 0 RA / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Antinuclear antibody negative, Blindness, Lumbar puncture, Nuclear magnetic resonance imaging, Papilloedema, Thyroxine decreased, Ultrasound eye abnormal, Ultrasound scan, Visual acuity reduced, Visual field defect, Visual field tests, Visual field tests abnormal, Visual impairment, White blood cell count increased, CSF test abnormal, Optic nerve disorder, Antibody test negative, Blood test

Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NO
Preexisting Conditions: NO 12/04/09 PMH: right knee plica; sinusitis; acne; NKDA.
Diagnostic Lab Data: SPINAL TAP, BLOOD WORK, MRI, VISUAL FIELD AND ULTRASOUNDS AND BAYBE OTHERS 12/04/09 Labs/Diagnostics: MRI brain: normal; AB Bartonella: negative; Free T4: 0.73 (L); ANA: not detected; WBC 13.6 (H); CSF culture: rare WBCs; Ultrasound optic nerve: orbital echography of right eye showed enlarged optic nerve-sheath diameter with a positive 30 degree test. B-scan showed significant disc elevation; echo of left eye showed mild elevation and normal retrobulbar optic nerve with no evidence of increased subarachnoid fluid.
CDC 'Split Type':

Write-up:VISION PROBLEMS, SWOLLEN OPTIC NERVE, PAPILLEDEMA. WENT TO SPECIALISTS AND STARTED TESTING. HAD EYE EXAMS, ULTRASOUNDS OF EYES, SPINAL TAP, MRI, BLOOD WORK AND VISUAL FIELD. POSSIBLE OTHER TEST 12/04/09 Opthalmology records received for DOS 04/11/08-09/19/08. Pt. presents with difficulty with hand work x 1-2 weeks DX: papilledema 12/04/09 Medical records received for DOS 04/11/08, 04/16/08, 04/18/08, 04/29/08 12/04/09 Neuro-opthalmology records received for DOS 06/18/08 DX: visual fields enlarged blind spot, right eye; bilateral optic nerve drusen 12/04/09 PCP records received for DOS 03/09/07-07/10/09.


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