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This is VAERS ID 555257

History of Changes from the VAERS Wayback Machine

First Appeared on 12/14/2014

555257
VAERS Form:
Age:13.0
Gender:Female
Location:Illinois
Vaccinated:2012-01-03
Onset:2012-11-01
Submitted:2014-11-23
Entered:2014-11-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1359AA / 2 LA / IM

Administered by: Unknown      Purchased by: Private
Symptoms: Anxiety, Concussion, Convulsion, Depression, Head injury, Panic attack, Syncope, Tachycardia, Tremor, Neurological symptom, Postural orthostatic tachycardia syndrome

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: 4     Extended hospital stay? No
Previous Vaccinations: Swelling, Itching~Influenza (Seasonal) (no brand name)~1~14.92~Patient
Other Medications: None
Current Illness: No
Preexisting Conditions: Allergic to Eggs & Sulfa Meds
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Panic Attacks, Tachycardia. Syncope, Head Injuries, Concussions. Seizures. Convulsions. POTS (Postural Orthostatic Tachycardia Syndrome). Depression. Anxiety. Neurological Problems. Tremors.


Changed on 9/14/2017

555257 Before After
VAERS Form:(blank) 1
Age:13.0
Gender:Female
Location:Illinois
Vaccinated:2012-01-03
Onset:2012-11-01
Submitted:2014-11-23
Entered:2014-11-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1359AA / 2 3 LA / IM

Administered by: Unknown      Purchased by: Private
Symptoms: Anxiety, Concussion, Convulsion, Depression, Head injury, Panic attack, Syncope, Tachycardia, Tremor, Neurological symptom, Postural orthostatic tachycardia syndrome

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: 4     Extended hospital stay? No
Previous Vaccinations: Swelling, Itching~Influenza (Seasonal) (no brand name)~1~14.92~Patient
Other Medications: None
Current Illness: No
Preexisting Conditions: Allergic to Eggs & Sulfa Meds
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Panic Attacks, Tachycardia. Syncope, Head Injuries, Concussions. Seizures. Convulsions. POTS (Postural Orthostatic Tachycardia Syndrome). Depression. Anxiety. Neurological Problems. Tremors.


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