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This is VAERS ID 528923

History of Changes from the VAERS Wayback Machine

First Appeared on 5/16/2014

528923
VAERS Form:
Age:15.0
Gender:Male
Location:New York
Vaccinated:2011-03-08
Onset:2011-03-20
Submitted:2014-04-14
Entered:2014-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0664Z / 0 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Abdominal discomfort, Delusional perception, Electroencephalogram normal, Hallucination, Headache, Pyrexia, Staring, Vomiting, Drug screen negative, Psychotic disorder, Immediate post-injection reaction, Computerised tomogram head normal

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: 21     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: EEG, CAT scan of brain, Street Drug Tested - negative
CDC 'Split Type':

Write-up:Immediate upset stomach, headache, fever - eleven days later - vomiting, hallucinating and delusional, 6 hour vertical blank stare, loss of faculties - full psychotic break. 4 wk. hospitalized and again 6 months later.


Changed on 6/14/2014

528923 Before After
VAERS Form:
Age:15.0
Gender:Male
Location:New York
Vaccinated:2011-03-08
Onset:2011-03-20
Submitted:2014-04-14
Entered:2014-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0664Z / 0 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Abdominal discomfort, Delusional perception, Electroencephalogram normal, Hallucination, Headache, Pyrexia, Staring, Vomiting, Drug screen negative, Psychotic disorder, Immediate post-injection reaction, Computerised tomogram head normal

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: 21     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: EEG, CAT scan of brain, Street Drug Tested - negative
CDC 'Split Type':

Write-up:Immediate upset stomach, headache, fever - eleven days later - vomiting, hallucinating and delusional, 6 hour vertical blank stare, loss of faculties - full psychotic break. 4 wk. hospitalized and again 6 months later.


Changed on 3/14/2015

528923 Before After
VAERS Form:
Age:15.0
Gender:Male
Location:New York
Vaccinated:2011-03-08
Onset:2011-03-20
Submitted:2014-04-14
Entered:2014-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0664Z / 0 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Abdominal discomfort, Delusional perception, Electroencephalogram normal, Hallucination, Headache, Pyrexia, Staring, Vomiting, Drug screen negative, Psychotic disorder, Immediate post-injection reaction, Computerised tomogram head normal

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: 21     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: EEG, CAT scan of brain, Street Drug Tested - negative
CDC 'Split Type':

Write-up:Immediate upset stomach, headache, fever - eleven days later - vomiting, hallucinating and delusional, 6 hour vertical blank stare, loss of faculties - full psychotic break. 4 wk. hospitalized and again 6 months later.


Changed on 9/14/2017

528923 Before After
VAERS Form:(blank) 1
Age:15.0
Gender:Male
Location:New York
Vaccinated:2011-03-08
Onset:2011-03-20
Submitted:2014-04-14
Entered:2014-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0664Z / 0 1 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Abdominal discomfort, Delusional perception, Electroencephalogram normal, Hallucination, Headache, Pyrexia, Staring, Vomiting, Drug screen negative, Psychotic disorder, Immediate post-injection reaction, Computerised tomogram head normal

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: 21     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: EEG, CAT scan of brain, Street Drug Tested - negative
CDC 'Split Type':

Write-up:Immediate upset stomach, headache, fever - eleven days later - vomiting, hallucinating and delusional, 6 hour vertical blank stare, loss of faculties - full psychotic break. 4 wk. hospitalized and again 6 months later.


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