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This is VAERS ID 539967

History of Changes from the VAERS Wayback Machine

First Appeared on 9/14/2014

VAERS ID: 539967
Age:11.0
Gender:Female
Location:Michigan
Vaccinated:2012-06-29
Onset:2012-06-29
Submitted:2014-08-15
Entered:2014-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0963AA / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U4246AA / 1 LA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C4181AA / 6 RA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0573AA / 2 LA / IM

Administered by: Private      Purchased by: Other
Symptoms: Back pain, Breath holding, Electroencephalogram abnormal, Nuclear magnetic resonance imaging, Pain in extremity, Abnormal behaviour, Blood test

Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, days: 11     Extended hospital stay? No
Previous Vaccinations: 6/29/2012~HPV (Gardasil)~1~11.17~Patient|strange staring spells~HPV (Gardasil)~1~11.25~Patient
Other Medications: none
Current Illness: no
Preexisting Conditions: no
Diagnostic Lab Data: Jan 4 2013 MRI EEG Feb 2013 Extended EEG stay in hospital Jan 2 2013 Blood work August 2013 emergency hospital stay Feb 18 2014 Extended eeg hospital stay
CDC 'Split Type':

Write-up:Complained her back hurt and her legs hurt. Gave motrin then a few weeks later noticed strange activity. In December noticed she was holding her breath during this strange activity. Contacted doctor and they ordered eeg and mri eeg showed activity. Referred to neurologist


Changed on 10/14/2014

VAERS ID: 539967 Before After
Age:11.0
Gender:Female
Location:Michigan
Vaccinated:2012-06-29
Onset:2012-06-29
Submitted:2014-08-15
Entered:2014-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0963AA / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U4246AA / 1 LA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C4181AA / 6 RA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0573AA / 2 LA / IM

Administered by: Private      Purchased by: Other
Symptoms: Back pain, Breath holding, Electroencephalogram abnormal, Nuclear magnetic resonance imaging, Pain in extremity, Abnormal behaviour, Blood test

Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, days: 11     Extended hospital stay? No
Previous Vaccinations: 6/29/2012~HPV (Gardasil)~1~11.17~Patient|strange staring spells~HPV (Gardasil)~1~11.25~Patient
Other Medications: none None
Current Illness: no No
Preexisting Conditions: no No
Diagnostic Lab Data: Jan 4 2013 MRI EEG EEG; Feb 2013 Extended EEG stay in hospital hospital; Jan 2 2013 Blood work work; August 2013 emergency hospital stay stay; Feb 18 2014 Extended eeg EEGg hospital stay
CDC 'Split Type':

Write-up:Complained her back hurt and her legs hurt. Gave motrin Motrin then a few weeks later noticed strange activity. In December noticed she was holding her breath during this strange activity. Contacted doctor and they ordered eeg and mri eeg showed activity. Referred to neurologist neurologist.


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