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This is VAERS ID 273469

Case Details

VAERS ID: 273469 (history)  
Form: Version 1.0  
Age: 17.0  
Gender: Female  
Location: California  
Vaccinated:2007-01-01
Onset:2007-01-01
   Days after vaccination:0
Submitted: 2007-03-05
   Days after onset:63
Entered: 2007-03-06
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0012U / 1 UN / -

Administered by: Private       Purchased by: Other
Symptoms: Grand mal convulsion
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC Split Type: WAES0702USA04695

Write-up: Information has been received from a physician, via a company representative, concerning a 16 year old female patient who in January 2007 ("last month"), was vaccinated with the first dose, 0.5ml, of Gardasil. The physician reported that in January 2007 ("last month"), the patient experienced a grand mal seizure after receiving her first dose. In addition, the physician reported that the "patient has no history of seizures and was taken to the ER. The physician did not know if the patient was admitted. It was unknown if the patient recovered. Upon internal review, grand mal seizure was determined to be an other medical event. Additional information has been requested.


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