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This is VAERS ID 637234

History of Changes from the VAERS Wayback Machine

First Appeared on 6/14/2016

637234
VAERS Form:
Age:11.0
Gender:Female
Location:Georgia
Vaccinated:2015-10-16
Onset:2015-11-01
Submitted:2016-05-26
Entered:2016-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT) / MEDIMMUNE VACCINES, INC. FJ2099 / 2 - / IN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. L013429 / 0 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO) / NOVARTIS VACCINES AND DIAGNOSTICS M15031 / 0 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS H5299 / 0 RA / IM

Administered by: Private      Purchased by: Other
Symptoms: Arthralgia, Diarrhoea, Dyspnoea, Fatigue, Hypersomnia, Loss of consciousness, Seizure, Throat tightness, Vomiting, Abasia, Contusion, Activities of daily living impaired

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:
Current Illness: No illnesses at time of vaccine
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Throat closing could not breath, passing out, seizures, vomiting, diarrhea, unexplained bruising, extreme fatigue resulting in sleep for 12 hours plus. Severe joint pain, sometimes can''t even walk. Can''t attend school or play sports anymore.


Changed on 9/14/2017

637234 Before After
VAERS Form:(blank) 1
Age:11.0
Gender:Female
Location:Georgia
Vaccinated:2015-10-16
Onset:2015-11-01
Submitted:2016-05-26
Entered:2016-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT) / MEDIMMUNE VACCINES, INC. FJ2099 / 2 3 - NS / IN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. L013429 / 0 1 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO) / NOVARTIS VACCINES AND DIAGNOSTICS M15031 / 0 1 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS H5299 / 0 1 RA / IM

Administered by: Private      Purchased by: Other
Symptoms: Arthralgia, Diarrhoea, Dyspnoea, Fatigue, Hypersomnia, Loss of consciousness, Seizure, Throat tightness, Vomiting, Abasia, Contusion, Activities of daily living impaired

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:
Current Illness: No illnesses at time of vaccine
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Throat closing could not breath, passing out, seizures, vomiting, diarrhea, unexplained bruising, extreme fatigue resulting in sleep for 12 hours plus. Severe joint pain, sometimes can''t even walk. Can''t attend school or play sports anymore.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=637234&WAYBACKHISTORY=ON


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