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This is VAERS ID 274953

Case Details

VAERS ID: 274953 (history)  
Form: Version 1.0  
Age: 17.0  
Gender: Female  
Location: Arizona  
Vaccinated:2007-03-06
Onset:2007-03-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2007-03-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0960F / 1 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2115AA / 1 RA / IM

Administered by: Other       Purchased by: Public
Symptoms: Back pain, Discomfort, Dizziness, Headache, Nystagmus, Stridor
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Ocular motility disorders (narrow), Hypersensitivity (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? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Very minimal URI symptoms
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Done in hospital LP: clear fluid, 1 WBC, 0 RBC, Glucose WNL at 56, protein 19. WBC 16.3, 90% neutrophil. Influenza A and B negative. EEG: mildly abnormal EEG due to excessive presence of beta activity which could be drug related. The lack of epileptiform activity does not rule out seizure condition. MRI Brain: no evidence of acute intracranial hemorrhage. Bilateral small middle cranial fossa arachnoid cysts. No evidence of infarct. CT Brain:negative. C-reactive protein 6.99. Blood culture negative.urine culture negative. ESR elevated.
CDC Split Type:

Write-up: 1:30 Backache, headache, dizziness, generalized discomfort in clinic - call to facility for clarification of side effects, referred to Family Practice - developed stridor, nystagmus - transferred to facility reported at 4:30. Admitted to ICU. Discharged facility 3/9/07. 04/02/07-records received from facility-Fever and altered neurological status. Temp 101.2. Fell at clinic. Fainted. Presented to ER with nystagmus with mainly her gaze toward the right. Not speaking Hyperventilating. Fever a few days ago and had been sick with viral syndrome. PE pupils equal round reactive to light but she had nystagmus frequently every few seconds and mainly seemed with a right. Required interpreter but she had no spontaneous speech. Carpal pedal spasm. Summary for DOS 3/7-3/9/07. DC DX:Diseases disorders of nervous system. Convulsions, Tetany, bronchitis, nystagmus, altered mental status, hyperventilation, headache, lumbago, fever. 8/25/08-progress notes received-3/8/07 all symptoms have resolved discharged without any medications. Continues to experience being a little dizzy when walking.


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