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This is VAERS ID 503396

History of Changes from the VAERS Wayback Machine

First Appeared on 10/13/2013

503396
VAERS Form:
Age:15.0
Gender:Male
Location:California
Vaccinated:2012-06-21
Onset:2012-06-26
Submitted:2013-09-21
Entered:2013-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1696AA / 0 LA / IM

Administered by: Unknown      Purchased by: Private
Symptoms: Cardiomyopathy, Electroencephalogram abnormal, Hemiparesis, Nuclear magnetic resonance imaging brain abnormal, Ventricular arrhythmia, Ischaemic stroke, Echocardiogram abnormal

Life Threatening? Yes
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: 9     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Insulin
Current Illness: No
Preexisting Conditions: Diabetes, toe walker
Allergies:
Diagnostic Lab Data: Echo Cardio gram showing LV noncompaction cardiomyopathy; MRI of brain showing stroke right ischemic stroke; EEG showing ventricular arrthymias; He was transferred to another hospital
CDC 'Split Type':

Write-up:I do not know the time of the incident. But he presented to ER with left sided weakness. He was found to have had a stroke and to have LV noncompaction cardiomyopathy.


Changed on 6/14/2014

503396 Before After
VAERS Form:
Age:15.0
Gender:Male
Location:California
Vaccinated:2012-06-21
Onset:2012-06-26
Submitted:2013-09-21
Entered:2013-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1696AA / 0 LA / IM

Administered by: Unknown      Purchased by: Private
Symptoms: Cardiomyopathy, Electroencephalogram abnormal, Hemiparesis, Nuclear magnetic resonance imaging brain abnormal, Ventricular arrhythmia, Ischaemic stroke, Echocardiogram abnormal

Life Threatening? Yes
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: 9     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Insulin
Current Illness: No
Preexisting Conditions: Diabetes, toe walker
Allergies:
Diagnostic Lab Data: Echo Cardio gram showing LV noncompaction cardiomyopathy; MRI of brain showing stroke right ischemic stroke; EEG showing ventricular arrthymias; He was transferred to another hospital
CDC 'Split Type':

Write-up:I do not know the time of the incident. But he presented to ER with left sided weakness. He was found to have had a stroke and to have LV noncompaction cardiomyopathy.


Changed on 3/14/2015

503396 Before After
VAERS Form:
Age:15.0
Gender:Male
Location:California
Vaccinated:2012-06-21
Onset:2012-06-26
Submitted:2013-09-21
Entered:2013-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1696AA / 0 LA / IM

Administered by: Unknown      Purchased by: Private
Symptoms: Cardiomyopathy, Electroencephalogram abnormal, Hemiparesis, Nuclear magnetic resonance imaging brain abnormal, Ventricular arrhythmia, Ischaemic stroke, Echocardiogram abnormal

Life Threatening? Yes
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: 9     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Insulin
Current Illness: No
Preexisting Conditions: Diabetes, toe walker
Allergies:
Diagnostic Lab Data: Echo Cardio gram showing LV noncompaction cardiomyopathy; MRI of brain showing stroke right ischemic stroke; EEG showing ventricular arrthymias; He was transferred to another hospital
CDC 'Split Type':

Write-up:I do not know the time of the incident. But he presented to ER with left sided weakness. He was found to have had a stroke and to have LV noncompaction cardiomyopathy.


Changed on 9/14/2017

503396 Before After
VAERS Form:(blank) 1
Age:15.0
Gender:Male
Location:California
Vaccinated:2012-06-21
Onset:2012-06-26
Submitted:2013-09-21
Entered:2013-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1696AA / 0 1 LA / IM

Administered by: Unknown      Purchased by: Private
Symptoms: Cardiomyopathy, Electroencephalogram abnormal, Hemiparesis, Nuclear magnetic resonance imaging brain abnormal, Ventricular arrhythmia, Ischaemic stroke, Echocardiogram abnormal

Life Threatening? Yes
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: 9     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Insulin
Current Illness: No
Preexisting Conditions: Diabetes, toe walker
Allergies:
Diagnostic Lab Data: Echo Cardio gram showing LV noncompaction cardiomyopathy; MRI of brain showing stroke right ischemic stroke; EEG showing ventricular arrthymias; He was transferred to another hospital
CDC 'Split Type':

Write-up:I do not know the time of the incident. But he presented to ER with left sided weakness. He was found to have had a stroke and to have LV noncompaction cardiomyopathy.


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