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This is VAERS ID 566379

History of Changes from the VAERS Wayback Machine

First Appeared on 3/14/2015

566379
VAERS Form:
Age:15.0
Gender:Male
Location:Rhode Island
Vaccinated:2013-08-21
Onset:2013-12-11
Submitted:2015-02-21
Entered:2015-02-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. H015555 / 2 LA / IM

Administered by: Private      Purchased by: Other
Symptoms: Confusional state, Convulsion, Dysarthria, Electroencephalogram, Epilepsy, Fall, Gait disturbance, Head banging, Nuclear magnetic resonance imaging, Speech disorder, Laboratory test, Eye movement disorder, Blood test

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: None
Current Illness: None
Preexisting Conditions: Allergy to amoxil
Allergies:
Diagnostic Lab Data: Was diagnosed with Epilepsy by his Neurologist after bloodwork, EEG, MRI and other tests
CDC 'Split Type':

Write-up:Walking around, stumbling, mumbling, banging his head on a cabinet, falling over, eyes moving all over, slurred speak and then confusion. It lasted about 15 minutes and was considered a seizure in January 2014 following an ER visit due to a seizure.


Changed on 9/14/2017

566379 Before After
VAERS Form:(blank) 1
Age:15.0
Gender:Male
Location:Rhode Island
Vaccinated:2013-08-21
Onset:2013-12-11
Submitted:2015-02-21
Entered:2015-02-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. H015555 / 2 3 LA / IM

Administered by: Private      Purchased by: Other
Symptoms: Confusional state, Convulsion, Dysarthria, Electroencephalogram, Epilepsy, Fall, Gait disturbance, Head banging, Nuclear magnetic resonance imaging, Speech disorder, Laboratory test, Eye movement disorder, Blood test

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: None
Current Illness: None
Preexisting Conditions: Allergy to amoxil
Allergies:
Diagnostic Lab Data: Was diagnosed with Epilepsy by his Neurologist after bloodwork, EEG, MRI and other tests
CDC 'Split Type':

Write-up:Walking around, stumbling, mumbling, banging his head on a cabinet, falling over, eyes moving all over, slurred speak and then confusion. It lasted about 15 minutes and was considered a seizure in January 2014 following an ER visit due to a seizure.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=566379&WAYBACKHISTORY=ON


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