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This is VAERS ID 277167

Case Details

VAERS ID: 277167 (history)  
Form: Version 1.0  
Age:   
Gender: Female  
Location: Pennsylvania  
Vaccinated:2007-04-01
Onset:2007-04-01
   Days after vaccination:0
Submitted: 2007-04-20
   Days after onset:19
Entered: 2007-04-23
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK - / IM

Administered by: Other       Purchased by: Other
Symptoms: Convulsion, Gaze palsy
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Ocular motility disorders (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: WAES0704USA02668

Write-up: Information has been received from a physician concerning a 12-15 year old (exact age unknown) female patient who in April 2007, was vaccinated with a dose of Gardasil. The patient started to convulse in front of the physician and her eyes rolled back after receiving the Gardasil. The patient received medical attention. The physician''s office followed up with the patient the next day and she was doing fine. Upon internal review, convulsion was considered to be an other important medical event. The physician reported that another patient in the same age group convulsed after receiving the Gardasil. Additional information has been requested.


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