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This is VAERS ID 275961

Case Details

VAERS ID: 275961 (history)  
Form: Version 1.0  
Age: 16.0  
Gender: Female  
Location: New Jersey  
Vaccinated:2007-02-28
Onset:2007-03-18
   Days after vaccination:18
Submitted: 2007-04-10
   Days after onset:23
Entered: 2007-04-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB143BA / 1 - / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0187U / 1 - / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B014AA / 6 - / IM

Administered by: Private       Purchased by: Private
Symptoms: Electroencephalogram abnormal, Grand mal convulsion, Headache, Hypoaesthesia, Nausea
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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: Lamictal
Current Illness: None
Preexisting Conditions: Epilepsy, recurrent headaches
Allergies:
Diagnostic Lab Data: EEG --$g B/L abnormal activity
CDC Split Type:

Write-up: 22 Days after receiving the above vaccines, she experienced numbness in her right hand and a headache and nausea. The next morning those symptoms were resolved. After being awake for 10 minutes she had a grand mal seizure. Duration 2-3 minutes. Emergency evaluation revealed a normal exam. PMH - significant for epilepsy. Dx 11/05 on Lamictal last seizure 1/06.


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