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This is VAERS ID 497496

History of Changes from the VAERS Wayback Machine

First Appeared on 8/12/2013

497496
VAERS Form:
Age:13.0
Gender:Female
Location:Illinois
Vaccinated:2012-04-16
Onset:2012-04-17
Submitted:2013-07-23
Entered:2013-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1495AA / 1 LA / IM

Administered by: Unknown      Purchased by: Private
Symptoms: Amnesia, Dizziness, Dystonia, Electroencephalogram normal, Headache, Nuclear magnetic resonance imaging brain normal, Vomiting, Abasia, Laboratory test normal, Psychogenic seizure, CSF test normal, Antinuclear antibody positive, Anti-NMDA antibody negative

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? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Respiridone 0.5 mg, Sertraline 75 mg
Current Illness: Potentially had dizziness and vomiting
Preexisting Conditions: Bipolar disorder, developmental delays
Allergies:
Diagnostic Lab Data: CSF studies were normal; NMDA testing was normal; MRI of brain was normal; multiple EEGs were normal; unremarkable serum chemistries; child did have positive ribonucleoprotein antibody
CDC 'Split Type':

Write-up:Child had vomiting, dizziness, that proceeded to headaches, over ensuing weeks, child developed amnesia, dystonia, and lost ability to walk; child had multiple pseudoseizures.


Changed on 9/17/2013

497496 Before After
VAERS Form:
Age:13.0
Gender:Female
Location:Illinois
Vaccinated:2012-04-16
Onset:2012-04-17
Submitted:2013-07-23
Entered:2013-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1495AA / 1 LA / IM

Administered by: Unknown      Purchased by: Private
Symptoms: Amnesia, Dizziness, Dystonia, Electroencephalogram normal, Headache, Nuclear magnetic resonance imaging brain normal, Vomiting, Abasia, Laboratory test normal, Psychogenic seizure, CSF test normal, Antinuclear antibody positive, Anti-NMDA antibody negative

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? Yes, days: (blank) 15     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Respiridone 0.5 mg, Sertraline 75 mg
Current Illness: Potentially had dizziness and vomiting
Preexisting Conditions: Bipolar disorder, developmental delays
Allergies:
Diagnostic Lab Data: CSF studies were normal; NMDA testing was normal; MRI of brain was normal; multiple EEGs were normal; unremarkable serum chemistries; child did have positive ribonucleoprotein antibody
CDC 'Split Type':

Write-up:Child had vomiting, dizziness, that proceeded to headaches, over ensuing weeks, child developed amnesia, dystonia, and lost ability to walk; child had multiple pseudoseizures.


Changed on 6/14/2014

497496 Before After
VAERS Form:
Age:13.0
Gender:Female
Location:Illinois
Vaccinated:2012-04-16
Onset:2012-04-17
Submitted:2013-07-23
Entered:2013-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1495AA / 1 LA / IM

Administered by: Unknown      Purchased by: Private
Symptoms: Amnesia, Dizziness, Dystonia, Electroencephalogram normal, Headache, Nuclear magnetic resonance imaging brain normal, Vomiting, Abasia, Laboratory test normal, Psychogenic seizure, CSF test normal, Antinuclear antibody positive, Anti-NMDA antibody negative

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? Yes, days: 15     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Respiridone 0.5 mg, Sertraline 75 mg
Current Illness: Potentially had dizziness and vomiting
Preexisting Conditions: Bipolar disorder, developmental delays
Allergies:
Diagnostic Lab Data: CSF studies were normal; NMDA testing was normal; MRI of brain was normal; multiple EEGs were normal; unremarkable serum chemistries; child did have positive ribonucleoprotein antibody
CDC 'Split Type':

Write-up:Child had vomiting, dizziness, that proceeded to headaches, over ensuing weeks, child developed amnesia, dystonia, and lost ability to walk; child had multiple pseudoseizures.


Changed on 7/14/2014

497496 Before After
VAERS Form:
Age:13.0
Gender:Female
Location:Illinois
Vaccinated:2012-04-16
Onset:2012-04-17
Submitted:2013-07-23
Entered:2013-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1495AA / 1 LA / IM

Administered by: Unknown      Purchased by: Private
Symptoms: Amnesia, Dizziness, Dystonia, Electroencephalogram normal, Headache, Nuclear magnetic resonance imaging brain normal, Vomiting, Abasia, Laboratory test normal, Psychogenic seizure, CSF test normal, Antinuclear antibody positive, Anti-NMDA antibody negative

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? Yes, days: 15     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Respiridone 0.5 mg, Sertraline 75 mg
Current Illness: Potentially had dizziness and vomiting
Preexisting Conditions: Bipolar disorder, developmental delays
Allergies:
Diagnostic Lab Data: CSF studies were normal; NMDA testing was normal; MRI of brain was normal; multiple EEGs were normal; unremarkable serum chemistries; child did have positive ribonucleoprotein antibody
CDC 'Split Type':

Write-up:Child had vomiting, dizziness, that proceeded to headaches, over ensuing weeks, child developed amnesia, dystonia, and lost ability to walk; child had multiple pseudoseizures.


Changed on 9/14/2017

497496 Before After
VAERS Form:(blank) 1
Age:13.0
Gender:Female
Location:Illinois
Vaccinated:2012-04-16
Onset:2012-04-17
Submitted:2013-07-23
Entered:2013-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1495AA / 1 2 LA / IM

Administered by: Unknown      Purchased by: Private
Symptoms: Amnesia, Dizziness, Dystonia, Electroencephalogram normal, Headache, Nuclear magnetic resonance imaging brain normal, Vomiting, Abasia, Laboratory test normal, Psychogenic seizure, CSF test normal, Antinuclear antibody positive, Anti-NMDA antibody negative

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? Yes, days: 15     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Respiridone 0.5 mg, Sertraline 75 mg
Current Illness: Potentially had dizziness and vomiting
Preexisting Conditions: Bipolar disorder, developmental delays
Allergies:
Diagnostic Lab Data: CSF studies were normal; NMDA testing was normal; MRI of brain was normal; multiple EEGs were normal; unremarkable serum chemistries; child did have positive ribonucleoprotein antibody
CDC 'Split Type':

Write-up:Child had vomiting, dizziness, that proceeded to headaches, over ensuing weeks, child developed amnesia, dystonia, and lost ability to walk; child had multiple pseudoseizures.


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