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This is VAERS ID 280396

Case Details

VAERS ID: 280396 (history)  
Form: Version 1.0  
Age: 18.0  
Gender: Female  
Location: Unknown  
Vaccinated:2007-05-31
Onset:2007-05-31
   Days after vaccination:0
Submitted: 2007-06-04
   Days after onset:4
Entered: 2007-06-05
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0389U / 2 - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Convulsion, Erythema, Fall, Feeling abnormal, Hypotension, Injection site erythema, Injection site streaking, Pallor, Tremor
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Dementia (broad), Convulsions (narrow), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: cough, cold and flu therapies
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: blood pressure 05/31/07 - "a little low"
CDC Split Type: WAES0706USA00016

Write-up: Information has been received from a nurse practitioner (NP) concerning an 18 year old female who on 31-MAY-2007 was vaccinated with Gardasil (LOT # 657736/0389U). Concomitant therapy included a cough expectorant (unspecified), which was taken on the same morning. On 31-MAY-2007, the patient went out to the reception area after she received her second Gardasil, and began "shaking and fell down". The NP reported that she thought that the patient had experienced "a short seizure that lasted about 15 seconds". The NP also reported that the patient had three red streaks running down her arm from the injection site area and that the patient stated she felt a rush down her arm at the time she was vaccinated. The patient''s blood pressure was "a little low" and her lips were pale. The patient was sent to an urgent care facility to be further evaluated. The nurse indicated that the patient did not have a reaction to the first dose of Gardasil. Upon internal review, seizure was determined to be an other important medical event. Additional information has been requested.


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