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This is VAERS ID 591256

History of Changes from the VAERS Wayback Machine

First Appeared on 9/14/2015

VAERS ID: 591256
VAERS Form:
Age:12.0
Gender:Male
Location:California
Vaccinated:2015-03-09
Onset:2015-03-14
Submitted:2015-08-14
Entered:2015-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. K006960 / 0 LA / UN

Administered by: Private      Purchased by: Other
Symptoms: Dyskinesia, Tic, Trismus

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? No
Previous Vaccinations:
Other Medications: None
Current Illness: None-annual check-up
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Have taken him to his regular Pediatrician and Neurologist who has diagnosed him with tics.
CDC 'Split Type':

Write-up: Vaccine administered 3/9-within a few days my son was making involuntary neck/shoulder movements. 2nd vaccination was on 5/27-started having involuntary jaw movements a few days later.


Changed on 9/14/2017

VAERS ID: 591256 Before After
VAERS Form:(blank) 1
Age:12.0
Gender:Male
Location:California
Vaccinated:2015-03-09
Onset:2015-03-14
Submitted:2015-08-14
Entered:2015-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. K006960 / 0 1 LA / UN

Administered by: Private      Purchased by: Other
Symptoms: Dyskinesia, Tic, Trismus

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? No
Previous Vaccinations:
Other Medications: None
Current Illness: None-annual check-up
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Have taken him to his regular Pediatrician and Neurologist who has diagnosed him with tics.
CDC 'Split Type':

Write-up: Vaccine administered 3/9-within a few days my son was making involuntary neck/shoulder movements. 2nd vaccination was on 5/27-started having involuntary jaw movements a few days later.


Changed on 2/14/2018

VAERS ID: 591256 Before After
VAERS Form:1
Age:12.0
Gender:Male
Location:California
Vaccinated:2015-03-09
Onset:2015-03-14
Submitted:2015-08-14
Entered:2015-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. K006960 / 1 LA / UN

Administered by: Private      Purchased by: Other
Symptoms: Dyskinesia, Tic, Trismus

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? No
Previous Vaccinations:
Other Medications: None
Current Illness: None-annual check-up
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Have taken him to his regular Pediatrician and Neurologist who has diagnosed him with tics.
CDC 'Split Type':

Write-up: Vaccine administered 3/9-within a few days my son was making involuntary neck/shoulder movements. 2nd vaccination was on 5/27-started having involuntary jaw movements a few days later.


Changed on 6/14/2018

VAERS ID: 591256 Before After
VAERS Form:1
Age:12.0
Gender:Male
Location:California
Vaccinated:2015-03-09
Onset:2015-03-14
Submitted:2015-08-14
Entered:2015-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. K006960 / 1 LA / UN

Administered by: Private      Purchased by: Other
Symptoms: Dyskinesia, Tic, Trismus

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? No
Previous Vaccinations:
Other Medications: None
Current Illness: None-annual check-up
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Have taken him to his regular Pediatrician and Neurologist who has diagnosed him with tics.
CDC 'Split Type':

Write-up: Vaccine administered 3/9-within a few days my son was making involuntary neck/shoulder movements. 2nd vaccination was on 5/27-started having involuntary jaw movements a few days later.

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=591256&WAYBACKHISTORY=ON


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