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This is VAERS ID 264761

Case Details

VAERS ID: 264761 (history)  
Age: 18.0  
Gender: Female  
Location: Pennsylvania  
Vaccinated:2006-08-15
Onset:2006-08-15
   Days after vaccination:0
Submitted: 2006-10-13
   Days after onset:59
Entered: 2006-10-17
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0641F / 0 RA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2151AC / 0 LA / IM

Administered by: Private       Purchased by: Military
Symptoms: Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: TUBERSOL, Aventis Pasteur, C2250AB
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type: WAES0609USA05927

Write-up: Information has been received from a physician concerning his "around 18" year old daughter who was vaccinated IM with a 0.5 ml dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). Concomitant therapy included a dose of diphtheria toxoid (+) pertussis acellular 3-component vaccine (+) tetanus toxoid (BOOSTRIX). Subsequently, the patient experienced numbness in her arms and lower extremities. Unspecified medical attention was sought. On an unspecified date, the patient recovered. No product quality complaint was involved. Additional information has been requested. 01/05/2007 Information has been received from a physician and health professional concerning an 18 year old female student with no medical history or allergies, who on 15-AUG-2006 at 09:00 was vaccinated IM into the right arm with a 0.5 ml first dose of GARDASIL (lot# 653650/0641F). Concomitant therapy included a first IM dose into the left arm of ADACEL (batch # C2151AC) and TUBERSOL (batch#C2250AB). On 15-AUG-2006 at 12:00, the patient experienced numbness in her arms and lower extremities. Unspecified medical attention was sought. No diagnostic laboratory studies were performed. On 21-AUG-2006, the patient recovered completely. Additional information is not expected.


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