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This is VAERS ID 551820

Case Details

VAERS ID: 551820 (history)  
Form: Version 1.0  
Age: 12.0  
Gender: Female  
Location: Ohio  
   Days after vaccination:0
Submitted: 2014-11-04
   Days after onset:1058
Entered: 2014-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Public       Purchased by: Private
Symptoms: Abdominal distension, Abdominal pain upper, Amenorrhoea, Anger, Arthralgia, Autoimmune disorder, Back pain, Bladder spasm, Blood iron decreased, Cognitive disorder, Convulsion, Dizziness, Fatigue, Groin pain, Headache, Hyperhidrosis, Hypoaesthesia, Immunology test abnormal, Memory impairment, Nausea, Night sweats, Pain, Palpitations, Papilloedema, Stomatitis, Swelling, Vision blurred, Weight increased
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Convulsions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Optic nerve disorders (narrow), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Osteonecrosis (broad), Fertility disorders (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations: severe pain all over, nausea, headache, swollen optic nerves, day night sweats, abdominal pain, bladder spasms, legs hand go num
Other Medications:
Current Illness: Stomach pain, nausea, bloating, headache, dizziness
Preexisting Conditions:
Diagnostic Lab Data: Swollen optic nerves, positive for auto immune disorder, low iron
CDC Split Type:

Write-up: Nausea, bloated, stomach pain, headache, dizziness, racing heart, hands feet go numb, comprehension and memory problems, extreme fatigue, chronic all over pain, sharp shooting pains into groin, vision blurred, swollen optic nerves, bladder spams, day and night sweats, absence periods, weight gain, mouth sores, hip pain, back pain, racing heart, quick to anger, lag out seizures.

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