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This is VAERS ID 671888

History of Changes from the VAERS Wayback Machine

First Appeared on 12/14/2016

VAERS ID: 671888
VAERS Form:
Age:13.0
Gender:Female
Location:Vermont
Vaccinated:2016-12-06
Onset:2016-12-07
Submitted:2016-12-07
Entered:2016-12-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU4: INFLUENZA (SEASONAL) (FLUZONE QUADRIVALENT) / SANOFI PASTEUR UI684AB / 9 LA / IM
HPV9: HPV (GARDASIL 9) / MERCK & CO. INC. M016193 / 2 RA / IM

Administered by: Private      Purchased by: Other
Symptoms: Blindness transient, Dizziness, Head injury, Headache, Vision blurred

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: No illness
Preexisting Conditions: Entoptic phenomenon; no other dxs; no allergies
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Received vaccine 12/6/16 no adverse symptoms or events until 12/7/16 at 0515 while pt in shower. Pt began to feel lightheaded, dizzy, (+) blurred vision. About 30 sec couldn''t see. No LOC. Hit head (right side). Frontal H/A rates 2/10. Negative for N/V.


Changed on 9/14/2017

VAERS ID: 671888 Before After
VAERS Form:(blank) 1
Age:13.0
Gender:Female
Location:Vermont
Vaccinated:2016-12-06
Onset:2016-12-07
Submitted:2016-12-07
Entered:2016-12-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU4: INFLUENZA (SEASONAL) (FLUZONE QUADRIVALENT) / SANOFI PASTEUR UI684AB / 9 7+ LA / IM
HPV9: HPV (GARDASIL 9) / MERCK & CO. INC. M016193 / 2 3 RA / IM

Administered by: Private      Purchased by: Other
Symptoms: Blindness transient, Dizziness, Head injury, Headache, Vision blurred

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: No illness
Preexisting Conditions: Entoptic phenomenon; no other dxs; no allergies
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Received vaccine 12/6/16 no adverse symptoms or events until 12/7/16 at 0515 while pt in shower. Pt began to feel lightheaded, dizzy, (+) blurred vision. About 30 sec couldn''t see. No LOC. Hit head (right side). Frontal H/A rates 2/10. Negative for N/V.


Changed on 2/14/2018

VAERS ID: 671888 Before After
VAERS Form:1
Age:13.0
Gender:Female
Location:Vermont
Vaccinated:2016-12-06
Onset:2016-12-07
Submitted:2016-12-07
Entered:2016-12-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU4: INFLUENZA (SEASONAL) (FLUZONE QUADRIVALENT) / SANOFI PASTEUR UI684AB / 7+ LA / IM
HPV9: HPV (GARDASIL 9) / MERCK & CO. INC. M016193 / 3 RA / IM

Administered by: Private      Purchased by: Other
Symptoms: Blindness transient, Dizziness, Head injury, Headache, Vision blurred

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: No illness
Preexisting Conditions: Entoptic phenomenon; no other dxs; no allergies
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Received vaccine 12/6/16 no adverse symptoms or events until 12/7/16 at 0515 while pt in shower. Pt began to feel lightheaded, dizzy, (+) blurred vision. About 30 sec couldn''t see. No LOC. Hit head (right side). Frontal H/A rates 2/10. Negative for N/V.


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Link To This Search Result:

http://medalerts.org/vaersdb/findfield.php?IDNUMBER=671888&WAYBACKHISTORY=ON


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