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This is VAERS ID 411924

History of Changes from the VAERS Wayback Machine

First Appeared on 12/7/2010

VAERS ID: 411924
VAERS Form:
Age:17.0
Gender:Female
Location:New Mexico
Vaccinated:2010-11-29
Onset:2010-11-29
Submitted:2010-11-29
Entered:2010-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU(10-11): INFLUENZA (SEASONAL) (FLUZONE 10-11) / SANOFI PASTEUR U3566AA / 0 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1778Y / 1 RA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Amnesia, Convulsion

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: Sinusitis/upper respiratory infection
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Nurse giving injection, patient and mom were present when apparent seizure took place. I was called stat to room where pt was sitting in a chair. Apparently patient was sitting on exam table when the HPV (2nd inj) was given and she began her seizure activity. She is amnestic of event.


Changed on 4/13/2011

VAERS ID: 411924 Before After
VAERS Form:
Age:17.0
Gender:Female
Location:New Mexico
Vaccinated:2010-11-29
Onset:2010-11-29
Submitted:2010-11-29
Entered:2010-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU(10-11): INFLUENZA (SEASONAL) (FLUZONE 10-11) / SANOFI PASTEUR U3566AA / 0 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1778Y / 1 RA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Acute sinusitis, Amnesia, Blood sodium decreased, Convulsion, Headache, Nasal congestion, Nausea, Red blood cells urine positive, Tremor, White blood cell count decreased, White blood cells urine positive, Mean platelet volume increased, Adverse drug reaction, Immediate post-injection reaction, Bacterial test, Oropharyngeal pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: Sinusitis/upper respiratory infection
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Nurse giving injection, patient and mom were present when apparent seizure took place. I was called stat to room where pt was sitting in a chair. Apparently patient was sitting on exam table when the HPV (2nd inj) was given and she began her seizure activity. She is amnestic of event.


Changed on 5/13/2011

VAERS ID: 411924 Before After
VAERS Form:
Age:17.0
Gender:Female
Location:New Mexico
Vaccinated:2010-11-29
Onset:2010-11-29
Submitted:2010-11-29
Entered:2010-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU(10-11): INFLUENZA (SEASONAL) (FLUZONE 10-11) / SANOFI PASTEUR U3566AA / 0 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1778Y / 1 RA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Acute sinusitis, Amnesia, Blood sodium decreased, Convulsion, Headache, Nasal congestion, Nausea, Red blood cells urine positive, Tremor, White blood cell count decreased, White blood cells urine positive, Mean platelet volume increased, Adverse drug reaction, Immediate post-injection reaction, Bacterial test, Oropharyngeal pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: Sinusitis/upper respiratory infection
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Nurse giving injection, patient and mom were present when apparent seizure took place. I was called stat to room where pt was sitting in a chair. Apparently patient was sitting on exam table when the HPV (2nd inj) was given and she began her seizure activity. She is amnestic of event.


Changed on 7/12/2011

VAERS ID: 411924 Before After
VAERS Form:
Age:17.0
Gender:Female
Location:New Mexico
Vaccinated:2010-11-29
Onset:2010-11-29
Submitted:2010-11-29
Entered:2010-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U3566AA / 0 LA / IM
FLU(10-11): INFLUENZA (SEASONAL) (FLUZONE 10-11) / SANOFI PASTEUR U3566AA / 0 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1778Y / 1 RA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Amnesia, Convulsion

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: Sinusitis/upper respiratory infection
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Nurse giving injection, patient and mom were present when apparent seizure took place. I was called stat to room where pt was sitting in a chair. Apparently patient was sitting on exam table when the HPV (2nd inj) was given and she began her seizure activity. She is amnestic of event.


Changed on 7/7/2013

VAERS ID: 411924 Before After
VAERS Form:
Age:17.0
Gender:Female
Location:New Mexico
Vaccinated:2010-11-29
Onset:2010-11-29
Submitted:2010-11-29
Entered:2010-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U3566AA / 0 LA / IM
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U3566AA / 0 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1778Y / 1 RA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Amnesia, Convulsion

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: Sinusitis/upper respiratory infection
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Nurse giving injection, patient and mom were present when apparent seizure took place. I was called stat to room where pt was sitting in a chair. Apparently patient was sitting on exam table when the HPV (2nd inj) was given and she began her seizure activity. She is amnestic of event.


Changed on 6/14/2014

VAERS ID: 411924 Before After
VAERS Form:
Age:17.0
Gender:Female
Location:New Mexico
Vaccinated:2010-11-29
Onset:2010-11-29
Submitted:2010-11-29
Entered:2010-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U3566AA / 0 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1778Y / 1 RA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Amnesia, Convulsion

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: Sinusitis/upper respiratory infection
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Nurse giving injection, patient and mom were present when apparent seizure took place. I was called stat to room where pt was sitting in a chair. Apparently patient was sitting on exam table when the HPV (2nd inj) was given and she began her seizure activity. She is amnestic of event.


Changed on 4/14/2017

VAERS ID: 411924 Before After
VAERS Form:
Age:17.0
Gender:Female
Location:New Mexico
Vaccinated:2010-11-29
Onset:2010-11-29
Submitted:2010-11-29
Entered:2010-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U3566AA / 0 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1778Y / 1 RA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Amnesia, Convulsion

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: Sinusitis/upper respiratory infection
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Nurse giving injection, patient and mom were present when apparent seizure took place. I was called stat to room where pt was sitting in a chair. Apparently patient was sitting on exam table when the HPV (2nd inj) was given and she began her seizure activity. She is amnestic of event.


Changed on 9/14/2017

VAERS ID: 411924 Before After
VAERS Form:(blank) 1
Age:17.0
Gender:Female
Location:New Mexico
Vaccinated:2010-11-29
Onset:2010-11-29
Submitted:2010-11-29
Entered:2010-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U3566AA / 0 1 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1778Y / 1 2 RA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Amnesia, Convulsion

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: Sinusitis/upper respiratory infection
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Nurse giving injection, patient and mom were present when apparent seizure took place. I was called stat to room where pt was sitting in a chair. Apparently patient was sitting on exam table when the HPV (2nd inj) was given and she began her seizure activity. She is amnestic of event.


Changed on 2/14/2018

VAERS ID: 411924 Before After
VAERS Form:1
Age:17.0
Gender:Female
Location:New Mexico
Vaccinated:2010-11-29
Onset:2010-11-29
Submitted:2010-11-29
Entered:2010-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U3566AA / 1 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1778Y / 2 RA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Amnesia, Convulsion

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: Sinusitis/upper respiratory infection
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Nurse giving injection, patient and mom were present when apparent seizure took place. I was called stat to room where pt was sitting in a chair. Apparently patient was sitting on exam table when the HPV (2nd inj) was given and she began her seizure activity. She is amnestic of event.


Changed on 6/14/2018

VAERS ID: 411924 Before After
VAERS Form:1
Age:17.0
Gender:Female
Location:New Mexico
Vaccinated:2010-11-29
Onset:2010-11-29
Submitted:2010-11-29
Entered:2010-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U3566AA / 1 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1778Y / 2 RA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Amnesia, Convulsion

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: Sinusitis/upper respiratory infection
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Nurse giving injection, patient and mom were present when apparent seizure took place. I was called stat to room where pt was sitting in a chair. Apparently patient was sitting on exam table when the HPV (2nd inj) was given and she began her seizure activity. She is amnestic of event.


Changed on 8/14/2018

VAERS ID: 411924 Before After
VAERS Form:1
Age:17.0
Gender:Female
Location:New Mexico
Vaccinated:2010-11-29
Onset:2010-11-29
Submitted:2010-11-29
Entered:2010-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U3566AA / 1 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1778Y / 2 RA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Amnesia, Convulsion

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: Sinusitis/upper respiratory infection
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Nurse giving injection, patient and mom were present when apparent seizure took place. I was called stat to room where pt was sitting in a chair. Apparently patient was sitting on exam table when the HPV (2nd inj) was given and she began her seizure activity. She is amnestic of event.


Changed on 9/14/2018

VAERS ID: 411924 Before After
VAERS Form:1
Age:17.0
Gender:Female
Location:New Mexico
Vaccinated:2010-11-29
Onset:2010-11-29
Submitted:2010-11-29
Entered:2010-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U3566AA / 1 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1778Y / 2 RA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Amnesia, Convulsion

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: Sinusitis/upper respiratory infection
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Nurse giving injection, patient and mom were present when apparent seizure took place. I was called stat to room where pt was sitting in a chair. Apparently patient was sitting on exam table when the HPV (2nd inj) was given and she began her seizure activity. She is amnestic of event.

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=411924&WAYBACKHISTORY=ON


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