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This is VAERS ID 277114

Case Details

VAERS ID: 277114 (history)  
Form: Version 1.0  
Age: 16.0  
Gender: Female  
Location: Unknown  
Submitted: 2007-04-19
Entered: 2007-04-20
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Abasia, Asthenia, Sensory loss, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0704USA03052

Write-up: Information has been received from physician''s assistant concerning a 16 year old female who was vaccinated intramuscularly with a 0.5 ml dose of Gardasil. it was reported that the patient was seen in the emergency room and the patient "collapsed, experienced weakness, sensory loss in extremities and the patient could not walk" after receiving Gardasil. The patient was hospitalized and the length of hospitalization was unknown. At the time of the report, it was unknown, if the patient recovered. The reporter considered collapsed, experienced weakness, sensory loss in extremities and could not walk to be disabling. Additional information has been requested.

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