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This is VAERS ID 262742

Case Details

VAERS ID: 262742 (history)  
Form: Version 1.0  
Age: 15.0  
Gender: Female  
Location: Virginia  
Vaccinated:2006-08-01
Onset:2006-08-01
   Days after vaccination:0
Submitted: 2006-09-05
   Days after onset:35
Entered: 2006-09-08
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. - / UNK UN / -
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK - / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR - / UNK UN / -

Administered by: Other       Purchased by: Other
Symptoms: Convulsion, Injection site pain
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: WAES0608USA06904

Write-up: Information has been received from a physician concerning a 15 year old female patient who in August 2006, was vaccinated IM with a dose of HPV rL1 6 11 16 18 VLP vaccine. Prior to administration, the patient received the following concomitant therapy: hepatitis A vaccine and meningococcal ACYW conjugate vaccine. The patient had a mild seizure after receiving HPV rL1 6 11 16 18 VLP vaccine injection. She also complained of a great deal of pain at injection site. Medical attention was sought. It was reported that the patient recovered 1 day after the event. Her mother called the physician at home 1 day after the injections to state that the patient was fine. Upon internal review, mild seizure was considered to be an other important medical event (OMIC). Additional information has been requested.


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