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This is VAERS ID 267171

Case Details

VAERS ID: 267171 (history)  
Age: 13.0  
Gender: Female  
Location: Minnesota  
Vaccinated:2006-11-10
Onset:2006-11-11
   Days after vaccination:1
Submitted: 2006-11-17
   Days after onset:6
Entered: 2006-11-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U2244AA / 1 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 08668F / 0 RA / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Facial palsy, Hypoaesthesia, Pain, Paralysis
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hearing impairment (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: INfluenza vaccine and Human Papilloma VIrus vaccines given November 10 about 11:45 AM. Patient woke up with numbness on right side of face on November 11. Presented to Emergency Room on November 12 with Bells Palsy of right side of face. Unable to move right side of face. Unable to close right eye. Previously healthy, no symptoms on day of vaccine administration. Received MR from pediatrician revealing a healthy 12 year old in for well-child exam. 24 hours after Flu and Gardasil vax. child developed numbness, pain, and inability to move the right side of face. Assessment: Facial Nerve Palsy-unclear etiology. Child was sent by car to Minneapolis Children''s ER to be evaluated. ER report received: DX: Bell''s Palsy


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