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This is VAERS ID 458894

History of Changes from the VAERS Wayback Machine

First Appeared on 7/13/2012

458894
VAERS Form:
Age:13.0
Gender:Female
Location:Indiana
Vaccinated:2011-09-28
Onset:2011-10-08
Submitted:2012-04-23
Entered:2012-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUN: INFLUENZA (SEASONAL) (FLUMIST) / MEDIMMUNE VACCINES, INC. 501105P / 1 - / IN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0636AA / 2 LA / IM

Administered by: Public      Purchased by: Private
Symptoms: Abdominal pain upper, Back pain, Blindness, Blood culture, Computerised tomogram, Lumbar puncture, Nuclear magnetic resonance imaging, Pyrexia, Skin lesion, Mobility decreased, Musculoskeletal stiffness, Blood test

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 32     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: CT scans; Multiple MRI''s; Spinal tap; Blood draws & cultures
CDC 'Split Type':

Write-up:Patient had symptoms start within two weeks of her shots. I took her to the ER & they sent her home symptoms grew worse and more presented so she was sent to hospital. Fever, lesions, back pain, stomach pain, stiff neck, loss of vision & use of legs.


Changed on 8/13/2012

458894 Before After
VAERS Form:
Age:13.0
Gender:Female
Location:Indiana
Vaccinated:2011-09-28
Onset:2011-10-08
Submitted:2012-04-23
Entered:2012-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUN: INFLUENZA (SEASONAL) (FLUMIST) / MEDIMMUNE VACCINES, INC. 501105P / 1 - / IN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0636AA / 2 LA / IM

Administered by: Public      Purchased by: Private
Symptoms: Abdominal pain upper, Back pain, Blindness, Blood culture, Computerised tomogram, Lumbar puncture, Nuclear magnetic resonance imaging, Pyrexia, Skin lesion, Mobility decreased, Musculoskeletal stiffness, Blood test

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 32 19     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: CT scans; Multiple MRI''s; Spinal tap; Blood draws & cultures
CDC 'Split Type':

Write-up:Patient had symptoms start within two weeks of her shots. I took her to the ER & they sent her home symptoms grew worse and more presented so she was sent to hospital. Fever, lesions, back pain, stomach pain, stiff neck, loss of vision & use of legs.


Changed on 7/7/2013

458894 Before After
VAERS Form:
Age:13.0
Gender:Female
Location:Indiana
Vaccinated:2011-09-28
Onset:2011-10-08
Submitted:2012-04-23
Entered:2012-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUN: INFLUENZA (SEASONAL) (FLUMIST) / MEDIMMUNE VACCINES, INC. 501105P / 1 - / IN
FLUN3: INFLUENZA (SEASONAL) (FLUMIST) / MEDIMMUNE VACCINES, INC. 501105P / 1 - / IN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0636AA / 2 LA / IM

Administered by: Public      Purchased by: Private
Symptoms: Abdominal pain upper, Back pain, Blindness, Blood culture, Computerised tomogram, Lumbar puncture, Nuclear magnetic resonance imaging, Pyrexia, Skin lesion, Mobility decreased, Musculoskeletal stiffness, Blood test

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 19     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: CT scans; Multiple MRI''s; Spinal tap; Blood draws & cultures
CDC 'Split Type':

Write-up:Patient had symptoms start within two weeks of her shots. I took her to the ER & they sent her home symptoms grew worse and more presented so she was sent to hospital. Fever, lesions, back pain, stomach pain, stiff neck, loss of vision & use of legs.


Changed on 9/14/2017

458894 Before After
VAERS Form:(blank) 1
Age:13.0
Gender:Female
Location:Indiana
Vaccinated:2011-09-28
Onset:2011-10-08
Submitted:2012-04-23
Entered:2012-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUN3: INFLUENZA (SEASONAL) (FLUMIST) / MEDIMMUNE VACCINES, INC. 501105P / 1 2 - NS / IN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0636AA / 2 3 LA / IM

Administered by: Public      Purchased by: Private
Symptoms: Abdominal pain upper, Back pain, Blindness, Blood culture, Computerised tomogram, Lumbar puncture, Nuclear magnetic resonance imaging, Pyrexia, Skin lesion, Mobility decreased, Musculoskeletal stiffness, Blood test

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 19     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: CT scans; Multiple MRI''s; Spinal tap; Blood draws & cultures
CDC 'Split Type':

Write-up:Patient had symptoms start within two weeks of her shots. I took her to the ER & they sent her home symptoms grew worse and more presented so she was sent to hospital. Fever, lesions, back pain, stomach pain, stiff neck, loss of vision & use of legs.


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