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This is VAERS ID 629822

History of Changes from the VAERS Wayback Machine

First Appeared on 4/14/2016

629822
VAERS Form:
Age:16.0
Gender:Male
Location:Wisconsin
Vaccinated:2013-10-23
Onset:2015-10-24
Submitted:2016-03-29
Entered:2016-03-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR UH920AC / 1 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. J007354 / 0 AR / IM

Administered by: Private      Purchased by: Private
Symptoms: Condition aggravated, Joint swelling, Sensory integrative dysfunction, Peripheral swelling, Neurological symptom, Oropharyngeal pain, Streptococcus test positive, Chronic tic disorder

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: enteroviral meningitis, sharp onset/exacerbation of neuromotor tics, sensory integration issues~DTaP + IPV (Unknown)~5~5.92~Pati
Other Medications: Patient possibly had previous reactions (sharp onset/exacerbation of sensory integration issues with sudden onset/exacerbations post vaccine, which lasted for months to years after several vaccines). I (mom) am a Pediatric Nurse Practitione
Current Illness: No known illness at the time of the vaccine.
Preexisting Conditions: Seasonal allergies. Diagnosis of Tourette Syndrome made after developing culture confirmed enteroviral meningitis post kindergarten vaccines and subsequent sudden onset of severe motor tics. History of other reactions post vaccines since he was very small, including sudden onset/exacerbation of severe, persistent irritability later diagnosed as sensory integration issues, motor tics and OCD which waxed and waned, with extremely sharp exacerbations post several vaccines.
Allergies:
Diagnostic Lab Data: Positive strep titre. Other labs and diagnostic testing available upon request.
CDC 'Split Type':

Write-up:Severe sensory integration issues/defensiveness leading to patient manually removing his orthodontia/braces, and sharp exacerbation in neuro-motor tics. Patient subsequently developed a persistent sore throat with negative strep culture by throat swab. 12/2013 patient''s neuromotor tics continued and vocal tics began. He experienced knee and finger joint swelling. His strep titre was positive ($g800) and he was treated with antibiotics. His sharply increased neurological symptoms persisted for several months, and the joint swelling recurred several times. His strep titre subsequently dropped to "normal".


Changed on 9/14/2017

629822 Before After
VAERS Form:(blank) 1
Age:16.0
Gender:Male
Location:Wisconsin
Vaccinated:2013-10-23
Onset:2015-10-24
Submitted:2016-03-29
Entered:2016-03-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR UH920AC / 1 2 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. J007354 / 0 1 AR / IM

Administered by: Private      Purchased by: Private
Symptoms: Condition aggravated, Joint swelling, Sensory integrative dysfunction, Peripheral swelling, Neurological symptom, Oropharyngeal pain, Streptococcus test positive, Chronic tic disorder

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: enteroviral meningitis, sharp onset/exacerbation of neuromotor tics, sensory integration issues~DTaP + IPV (Unknown)~5~5.92~Pati
Other Medications: Patient possibly had previous reactions (sharp onset/exacerbation of sensory integration issues with sudden onset/exacerbations post vaccine, which lasted for months to years after several vaccines). I (mom) am a Pediatric Nurse Practitione
Current Illness: No known illness at the time of the vaccine.
Preexisting Conditions: Seasonal allergies. Diagnosis of Tourette Syndrome made after developing culture confirmed enteroviral meningitis post kindergarten vaccines and subsequent sudden onset of severe motor tics. History of other reactions post vaccines since he was very small, including sudden onset/exacerbation of severe, persistent irritability later diagnosed as sensory integration issues, motor tics and OCD which waxed and waned, with extremely sharp exacerbations post several vaccines.
Allergies:
Diagnostic Lab Data: Positive strep titre. Other labs and diagnostic testing available upon request.
CDC 'Split Type':

Write-up:Severe sensory integration issues/defensiveness leading to patient manually removing his orthodontia/braces, and sharp exacerbation in neuro-motor tics. Patient subsequently developed a persistent sore throat with negative strep culture by throat swab. 12/2013 patient''s neuromotor tics continued and vocal tics began. He experienced knee and finger joint swelling. His strep titre was positive ($g800) and he was treated with antibiotics. His sharply increased neurological symptoms persisted for several months, and the joint swelling recurred several times. His strep titre subsequently dropped to "normal".


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