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This is VAERS ID 577937

History of Changes from the VAERS Wayback Machine

First Appeared on 6/13/2015

577937
VAERS Form:
Age:11.0
Gender:Female
Location:Arizona
Vaccinated:2010-06-25
Onset:0000-00-00
Submitted:2015-05-06
Entered:2015-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1013Y / 0 RA / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U3077AA / 0 RA / UN
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC5B040BA / 0 LA / UN
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1594Y / 1 UN / SC

Administered by: Private      Purchased by: Private
Symptoms: Computerised tomogram, Electroencephalogram abnormal, Epilepsy, Hypometabolism, Nausea, Nuclear magnetic resonance imaging, Positron emission tomogram, Seizure, Vomiting

Life Threatening? Yes
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: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: MRI, CT, PET scan, EEGs-hypometabolic (R) hemisphere intractable epilepsy
CDC 'Split Type':

Write-up:After last HPV had ongoing nausea and vomiting for over 6 months. Had 1st seizure May 2013. Seizures have continued. Normal development milestones with above avg intelligence.


Changed on 1/14/2016

577937 Before After
VAERS Form:
Age:11.0
Gender:Female
Location:Arizona
Vaccinated:2010-06-25
Onset:0000-00-00 2013-05-01
Submitted:2015-05-06
Entered:2015-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1013Y / 0 RA / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U3077AA / 0 RA / UN
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC5B040BA / 0 LA / UN
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1594Y / 1 UN / SC

Administered by: Private      Purchased by: Private
Symptoms: Computerised tomogram, Electroencephalogram abnormal, Epilepsy, Hypometabolism, Nausea, Nuclear magnetic resonance imaging, Positron emission tomogram, Seizure, Vomiting

Life Threatening? Yes
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: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: MRI, CT, PET scan, EEGs-hypometabolic (R) hemisphere intractable epilepsy
CDC 'Split Type':

Write-up:After last HPV had ongoing nausea and vomiting for over 6 months. Had 1st seizure May 2013. Seizures have continued. Normal development milestones with above avg intelligence.


Changed on 9/14/2017

577937 Before After
VAERS Form:(blank) 1
Age:11.0
Gender:Female
Location:Arizona
Vaccinated:2010-06-25
Onset:2013-05-01
Submitted:2015-05-06
Entered:2015-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1013Y / 0 1 RA / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U3077AA / 0 1 RA / UN
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC5B040BA / 0 1 LA / UN
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1594Y / 1 2 UN / SC

Administered by: Private      Purchased by: Private
Symptoms: Computerised tomogram, Electroencephalogram abnormal, Epilepsy, Hypometabolism, Nausea, Nuclear magnetic resonance imaging, Positron emission tomogram, Seizure, Vomiting

Life Threatening? Yes
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: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: MRI, CT, PET scan, EEGs-hypometabolic (R) hemisphere intractable epilepsy
CDC 'Split Type':

Write-up:After last HPV had ongoing nausea and vomiting for over 6 months. Had 1st seizure May 2013. Seizures have continued. Normal development milestones with above avg intelligence.


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