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This is VAERS ID 532797

History of Changes from the VAERS Wayback Machine

First Appeared on 6/14/2014

VAERS ID: 532797
VAERS Form:
Age:12.0
Sex:Female
Location:Wisconsin
Vaccinated:2007-10-02
Onset:2007-11-14
Submitted:2014-05-02
Entered:2014-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0181U / 0 LA / UN

Administered by: Public      Purchased by: Unknown
Symptoms: Convulsion, Death, Electrocardiogram normal, Electroencephalogram abnormal, Full blood count normal, Nuclear magnetic resonance imaging brain abnormal, Liver function test normal, Pineal gland cyst, Computerised tomogram head normal

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2014-01-11
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: ECG = normal sinus rhythm, normal ECG; Head MRI - Pineal cyst (6mm); Head CT - no evidence of acute intracranial abnormalities
CDC 'Split Type':

Write-up: 11/14/2007 - Seizure. Confirmed by EEG. Begun using DEPAKOTE. CBC and LFT''s - within nml limits.


Changed on 7/14/2014

VAERS ID: 532797 Before After
VAERS Form:
Age:12.0
Sex:Female
Location:Wisconsin
Vaccinated:2007-10-02
Onset:2007-11-14
Submitted:2014-05-02
Entered:2014-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0181U / 0 LA / UN IM

Administered by: Public      Purchased by: Unknown
Symptoms: Convulsion, Death, Electrocardiogram normal, Electroencephalogram abnormal, Full blood count normal, Nuclear magnetic resonance imaging brain abnormal, Liver function test normal, Pineal gland cyst, Computerised tomogram head normal

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2014-01-11
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: ECG = normal sinus rhythm, normal ECG; Head MRI - Pineal cyst (6mm); Head CT - no evidence of acute intracranial abnormalities
CDC 'Split Type':

Write-up: 11/14/2007 - Seizure. Confirmed by EEG. Begun using DEPAKOTE. CBC and LFT''s - within nml limits.


Changed on 8/14/2014

VAERS ID: 532797 Before After
VAERS Form:
Age:12.0
Sex:Female
Location:Wisconsin
Vaccinated:2007-10-02
Onset:2007-11-14
Submitted:2014-05-02
Entered:2014-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0181U / 0 LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Convulsion, Death, Electrocardiogram normal, Electroencephalogram abnormal, Full blood count normal, Nuclear magnetic resonance imaging brain abnormal, Liver function test normal, Pineal gland cyst, Computerised tomogram head normal

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2014-01-11
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: ECG = normal sinus rhythm, normal ECG; Head MRI - Pineal cyst (6mm); Head CT - no evidence of acute intracranial abnormalities
CDC 'Split Type':

Write-up: 11/14/2007 - Seizure. Confirmed by EEG. Begun using DEPAKOTE. CBC and LFT''s - within nml limits.


Changed on 9/14/2017

VAERS ID: 532797 Before After
VAERS Form:(blank) 1
Age:12.0
Sex:Female
Location:Wisconsin
Vaccinated:2007-10-02
Onset:2007-11-14
Submitted:2014-05-02
Entered:2014-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0181U / 0 1 LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Convulsion, Death, Electrocardiogram normal, Electroencephalogram abnormal, Full blood count normal, Nuclear magnetic resonance imaging brain abnormal, Liver function test normal, Pineal gland cyst, Computerised tomogram head normal

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2014-01-11
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? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: ECG = normal sinus rhythm, normal ECG; Head MRI - Pineal cyst (6mm); Head CT - no evidence of acute intracranial abnormalities
CDC 'Split Type':

Write-up: 11/14/2007 - Seizure. Confirmed by EEG. Begun using DEPAKOTE. CBC and LFT''s - within nml limits.


Changed on 2/14/2018

VAERS ID: 532797 Before After
VAERS Form:1
Age:12.0
Sex:Female
Location:Wisconsin
Vaccinated:2007-10-02
Onset:2007-11-14
Submitted:2014-05-02
Entered:2014-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0181U / 1 LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Convulsion, Death, Electrocardiogram normal, Electroencephalogram abnormal, Full blood count normal, Nuclear magnetic resonance imaging brain abnormal, Liver function test normal, Pineal gland cyst, Computerised tomogram head normal

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2014-01-11
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? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: ECG = normal sinus rhythm, normal ECG; Head MRI - Pineal cyst (6mm); Head CT - no evidence of acute intracranial abnormalities
CDC 'Split Type':

Write-up: 11/14/2007 - Seizure. Confirmed by EEG. Begun using DEPAKOTE. CBC and LFT''s - within nml limits.


Changed on 6/14/2018

VAERS ID: 532797 Before After
VAERS Form:1
Age:12.0
Sex:Female
Location:Wisconsin
Vaccinated:2007-10-02
Onset:2007-11-14
Submitted:2014-05-02
Entered:2014-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0181U / 1 LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Convulsion, Death, Electrocardiogram normal, Electroencephalogram abnormal, Full blood count normal, Nuclear magnetic resonance imaging brain abnormal, Liver function test normal, Pineal gland cyst, Computerised tomogram head normal

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2014-01-11
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? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: ECG = normal sinus rhythm, normal ECG; Head MRI - Pineal cyst (6mm); Head CT - no evidence of acute intracranial abnormalities
CDC 'Split Type':

Write-up: 11/14/2007 - Seizure. Confirmed by EEG. Begun using DEPAKOTE. CBC and LFT''s - within nml limits.


Changed on 8/14/2018

VAERS ID: 532797 Before After
VAERS Form:1
Age:12.0
Sex:Female
Location:Wisconsin
Vaccinated:2007-10-02
Onset:2007-11-14
Submitted:2014-05-02
Entered:2014-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0181U / 1 LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Convulsion, Death, Electrocardiogram normal, Electroencephalogram abnormal, Full blood count normal, Nuclear magnetic resonance imaging brain abnormal, Liver function test normal, Pineal gland cyst, Computerised tomogram head normal

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2014-01-11
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? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: ECG = normal sinus rhythm, normal ECG; Head MRI - Pineal cyst (6mm); Head CT - no evidence of acute intracranial abnormalities
CDC 'Split Type':

Write-up: 11/14/2007 - Seizure. Confirmed by EEG. Begun using DEPAKOTE. CBC and LFT''s - within nml limits.


Changed on 9/14/2018

VAERS ID: 532797 Before After
VAERS Form:1
Age:12.0
Sex:Female
Location:Wisconsin
Vaccinated:2007-10-02
Onset:2007-11-14
Submitted:2014-05-02
Entered:2014-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0181U / 1 LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Convulsion, Death, Electrocardiogram normal, Electroencephalogram abnormal, Full blood count normal, Nuclear magnetic resonance imaging brain abnormal, Liver function test normal, Pineal gland cyst, Computerised tomogram head normal

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2014-01-11
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? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: ECG = normal sinus rhythm, normal ECG; Head MRI - Pineal cyst (6mm); Head CT - no evidence of acute intracranial abnormalities
CDC 'Split Type':

Write-up: 11/14/2007 - Seizure. Confirmed by EEG. Begun using DEPAKOTE. CBC and LFT''s - within nml limits.


Changed on 10/14/2018

VAERS ID: 532797 Before After
VAERS Form:1
Age:12.0
Sex:Female
Location:Wisconsin
Vaccinated:2007-10-02
Onset:2007-11-14
Submitted:2014-05-02
Entered:2014-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0181U / 1 LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Convulsion, Death, Electrocardiogram normal, Electroencephalogram abnormal, Full blood count normal, Nuclear magnetic resonance imaging brain abnormal, Liver function test normal, Pineal gland cyst, Computerised tomogram head normal

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2014-01-11
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? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: ECG = normal sinus rhythm, normal ECG; Head MRI - Pineal cyst (6mm); Head CT - no evidence of acute intracranial abnormalities
CDC 'Split Type':

Write-up: 11/14/2007 - Seizure. Confirmed by EEG. Begun using DEPAKOTE. CBC and LFT''s - within nml limits.

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