National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 411387

History of Changes from the VAERS Wayback Machine

First Appeared on 12/7/2010

VAERS ID: 411387
Age:15.0
Gender:Male
Location:California
Vaccinated:2010-12-02
Onset:2010-12-02
Submitted:2010-12-03
Entered:2010-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU(10-11): INFLUENZA (SEASONAL) (FLUZONE 10-11) / SANOFI PASTEUR U3732AA / 1 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0992Z / 0 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Fall, Head injury, Tonic clonic movements

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:The child started having tonic clonic type movements, then fell and hit his head and continued with tonic clonic type movements. We activated EMS and child was taken to ED via ambulance.


Changed on 1/4/2011

VAERS ID: 411387 Before After
Age:15.0
Gender:Male
Location:California
Vaccinated:2010-12-02
Onset:2010-12-02
Submitted:2010-12-03
Entered:2010-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU(10-11): INFLUENZA (SEASONAL) (FLUZONE 10-11) / SANOFI PASTEUR U3732AA / 1 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0992Z / 0 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Fall, Head injury, Tonic clonic movements

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:The child started having tonic clonic type movements, then fell and hit his head and continued with tonic clonic type movements. We activated EMS and child was taken to ED via ambulance.


Changed on 4/13/2011

VAERS ID: 411387 Before After
Age:15.0
Gender:Male
Location:California
Vaccinated:2010-12-02
Onset:2010-12-02
Submitted:2010-12-03
Entered:2010-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU(10-11): INFLUENZA (SEASONAL) (FLUZONE 10-11) / SANOFI PASTEUR U3732AA / 1 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0992Z / 0 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Dizziness, Fall, Head injury, Pallor, Syncope, Tremor, Postictal state, Tonic clonic movements

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:The child started having tonic clonic type movements, then fell and hit his head and continued with tonic clonic type movements. We activated EMS and child was taken to ED via ambulance.


Changed on 5/13/2011

VAERS ID: 411387 Before After
Age:15.0
Gender:Male
Location:California
Vaccinated:2010-12-02
Onset:2010-12-02
Submitted:2010-12-03
Entered:2010-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU(10-11): INFLUENZA (SEASONAL) (FLUZONE 10-11) / SANOFI PASTEUR U3732AA / 1 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0992Z / 0 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Dizziness, Fall, Head injury, Pallor, Syncope, Tremor, Postictal state, Tonic clonic movements

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:The child started having tonic clonic type movements, then fell and hit his head and continued with tonic clonic type movements. We activated EMS and child was taken to ED via ambulance.


Changed on 7/12/2011

VAERS ID: 411387 Before After
Age:15.0
Gender:Male
Location:California
Vaccinated:2010-12-02
Onset:2010-12-02
Submitted:2010-12-03
Entered:2010-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U3732AA / 1 LA / IM
FLU(10-11): INFLUENZA (SEASONAL) (FLUZONE 10-11) / SANOFI PASTEUR U3732AA / 1 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0992Z / 0 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Fall, Head injury, Tonic clonic movements

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:The child started having tonic clonic type movements, then fell and hit his head and continued with tonic clonic type movements. We activated EMS and child was taken to ED via ambulance.


Changed on 7/7/2013

VAERS ID: 411387 Before After
Age:15.0
Gender:Male
Location:California
Vaccinated:2010-12-02
Onset:2010-12-02
Submitted:2010-12-03
Entered:2010-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U3732AA / 1 LA / IM
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U3732AA / 1 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0992Z / 0 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Fall, Head injury, Tonic clonic movements

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:The child started having tonic clonic type movements, then fell and hit his head and continued with tonic clonic type movements. We activated EMS and child was taken to ED via ambulance.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=411387&WAYBACKHISTORY=ON


Copyright © 2017 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166