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This is VAERS ID 273177

Case Details

VAERS ID: 273177 (history)  
Form: Version 1.0  
Age: 31.0  
Gender: Female  
Location: Unknown  
   Days after vaccination:0
Submitted: 2007-02-27
   Days after onset:77
Entered: 2007-02-28
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 1 - / IM

Administered by: Other       Purchased by: Other
Symptoms: Amnesia, Convulsion, Dyspnoea, Headache, Incoherent, Influenza like illness, Malaise, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Systemic lupus erythematosus (broad), Dementia (broad), Convulsions (narrow), Acute central respiratory depression (broad), Psychosis and psychotic disorders (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (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? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: GLUCOPHAGE
Current Illness: Type II diabetes mellitus, Sulfonamide allergy, Drug hypersensitivity, Penicillin allergy
Preexisting Conditions: Gastric bypass, gastric stapling reversal, asthma
Diagnostic Lab Data:
CDC Split Type: WAES0702USA03479

Write-up: Information has been received from a licensed practical nurse concerning a 31 year old female with type II diabetes mellitus, sulfa, morphine, DEMEROL and penicillin allergy and a history of gastric bypass (1994), reverse gastric bypass (1996) and mild asthma who on 12-DEC-2006 was vaccinated with her first dose of Gardasil (lot #653978/0955F), 0.5 ml, IM. Concomitant therapy included metformin HCL (GLUCOPHAGE). On 12-DEC-2006 less than one hour after receiving her first dose of Gardasil, the patient developed "Flu-Like" symptoms. The patient stated that she had a headache and nausea but was not sure if she had a fever. About ten hours after the initial vaccine was administered the patient had a convulsive seizure. The seizure lasted about 2 minutes. The patient was not coherent and was breathing heavy. After the seizure, the patient continued to fell ill and had no memory of the seizure. The patient did not go to the hospital. The patient''s husband was an EMT, so he attended to her but did not given her any medication. The patient had no prior history of seizures. The next day the patient felt better. Upon internal review, convulsive seizure was considered to be an other important medical event. Additional information has been requested.

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