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This is VAERS ID 267726

Case Details

VAERS ID: 267726 (history)  
Form: Version 1.0  
Age: 14.0  
Gender: Female  
Location: California  
   Days after vaccination:0
Submitted: 2006-11-20
   Days after onset:14
Entered: 2006-11-27
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Condition aggravated, Convulsion, Fall, Injury, Syncope, Syncope vasovagal
SMQs:, Torsade de pointes/QT prolongation (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hostility/aggression (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (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: UNK
Current Illness:
Preexisting Conditions: Convulsion
Diagnostic Lab Data:
CDC Split Type: WAES0611USA03470

Write-up: Information has been received from a physician and a medical assistant concerning a 14 year old female with a history of a prior seizure (on an unk date about a year ago during a hair cut) who on 11/6/06 was vaccinated IM in the deltoid with the second dose of HPV vaccine (lot not provided). It was reported that the pt had no difficulties when the first dose of the vaccine was administered on an unspecified date. On 11/6/06 the medical assistant administered the vaccine, then turned to discard the needle. The pt fainted, fell from the exam table, hit her head on the floor and had a seizure. Paramedics were called, a cervical collar was placed on the pt and she was transported to the ER. The pt was evaluated in the ER, a CT scan was performed which was reported as normal. The pt was discharged to home from the ER and instructed to follow up with neurology. The medical assistant stated that the physician felt that the pt had a vasovagal response after receiving the vaccine and that the seizure was a result of the head trauma which the pt suffered from the fall off the exam table. It was reported that the physician felt that the seizure was related to the head trauma and not related to the vaccine. The medical assistant also reported that the physician felt the pt had recovered from the event. Upon internal medical review the seizure was felt to be an important medical event (OMIC). Additional information has been requested.

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