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This is VAERS ID 276530

Case Details

VAERS ID: 276530 (history)  
Form: Version 1.0  
Age: 14.0  
Gender: Female  
Location: Georgia  
Vaccinated:2007-02-23
Onset:2007-02-23
   Days after vaccination:0
Submitted: 2007-04-16
   Days after onset:51
Entered: 2007-04-17
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK - / IM

Administered by: Other       Purchased by: Other
Symptoms: Convulsion, Fall
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0704USA01566

Write-up: Information has been received from a Certified Medical Assistant (C.M.A.) concerning a 14 year old female patient who on 23-FEB-2007 was vaccinated IM with 0.5 mL of Gardasil. On 23-FEB-2007 the patient fell to floor in a seizure like state. After 30 seconds she became conscious. Patient never had a seizure like episode before this incident. Unspecified medical attention was sought by the patient. The patient recovered the same day. Upon internal review, seizure was considered to be an other important medical event. Additional information has been requested.


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