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This is VAERS ID 521163

History of Changes from the VAERS Wayback Machine

First Appeared on 3/14/2014

VAERS ID: 521163
VAERS Form:
Age:15.0
Sex:Female
Location:Texas
Vaccinated:2014-01-22
Onset:2014-01-24
Submitted:2014-01-27
Entered:2014-01-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. J012212 / 1 LA / UN

Administered by: Private      Purchased by: Private
Symptoms: Convulsion

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Prematurity; E1A
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Received phone call from patient''s mother on 1/27/14 at 11:45am that child was awakened from sleep 1/24/14 having a seizure. Received notification from ER 1/28/14 that child had been admitted for evaluation of seizure.


Changed on 9/14/2017

VAERS ID: 521163 Before After
VAERS Form:(blank) 1
Age:15.0
Sex:Female
Location:Texas
Vaccinated:2014-01-22
Onset:2014-01-24
Submitted:2014-01-27
Entered:2014-01-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. J012212 / 1 2 LA / UN

Administered by: Private      Purchased by: Private
Symptoms: Convulsion

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Prematurity; E1A
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Received phone call from patient''s mother on 1/27/14 at 11:45am that child was awakened from sleep 1/24/14 having a seizure. Received notification from ER 1/28/14 that child had been admitted for evaluation of seizure.


Changed on 2/14/2018

VAERS ID: 521163 Before After
VAERS Form:1
Age:15.0
Sex:Female
Location:Texas
Vaccinated:2014-01-22
Onset:2014-01-24
Submitted:2014-01-27
Entered:2014-01-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. J012212 / 2 LA / UN

Administered by: Private      Purchased by: Private
Symptoms: Convulsion

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Prematurity; E1A
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Received phone call from patient''s mother on 1/27/14 at 11:45am that child was awakened from sleep 1/24/14 having a seizure. Received notification from ER 1/28/14 that child had been admitted for evaluation of seizure.


Changed on 6/14/2018

VAERS ID: 521163 Before After
VAERS Form:1
Age:15.0
Sex:Female
Location:Texas
Vaccinated:2014-01-22
Onset:2014-01-24
Submitted:2014-01-27
Entered:2014-01-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. J012212 / 2 LA / UN

Administered by: Private      Purchased by: Private
Symptoms: Convulsion

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Prematurity; E1A
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Received phone call from patient''s mother on 1/27/14 at 11:45am that child was awakened from sleep 1/24/14 having a seizure. Received notification from ER 1/28/14 that child had been admitted for evaluation of seizure.


Changed on 8/14/2018

VAERS ID: 521163 Before After
VAERS Form:1
Age:15.0
Sex:Female
Location:Texas
Vaccinated:2014-01-22
Onset:2014-01-24
Submitted:2014-01-27
Entered:2014-01-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. J012212 / 2 LA / UN

Administered by: Private      Purchased by: Private
Symptoms: Convulsion

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Prematurity; E1A
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Received phone call from patient''s mother on 1/27/14 at 11:45am that child was awakened from sleep 1/24/14 having a seizure. Received notification from ER 1/28/14 that child had been admitted for evaluation of seizure.


Changed on 9/14/2018

VAERS ID: 521163 Before After
VAERS Form:1
Age:15.0
Sex:Female
Location:Texas
Vaccinated:2014-01-22
Onset:2014-01-24
Submitted:2014-01-27
Entered:2014-01-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. J012212 / 2 LA / UN

Administered by: Private      Purchased by: Private
Symptoms: Convulsion

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Prematurity; E1A
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Received phone call from patient''s mother on 1/27/14 at 11:45am that child was awakened from sleep 1/24/14 having a seizure. Received notification from ER 1/28/14 that child had been admitted for evaluation of seizure.


Changed on 10/14/2018

VAERS ID: 521163 Before After
VAERS Form:1
Age:15.0
Sex:Female
Location:Texas
Vaccinated:2014-01-22
Onset:2014-01-24
Submitted:2014-01-27
Entered:2014-01-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. J012212 / 2 LA / UN

Administered by: Private      Purchased by: Private
Symptoms: Convulsion

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Prematurity; E1A
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Received phone call from patient''s mother on 1/27/14 at 11:45am that child was awakened from sleep 1/24/14 having a seizure. Received notification from ER 1/28/14 that child had been admitted for evaluation of seizure.

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=521163&WAYBACKHISTORY=ON


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