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This is VAERS ID 281378

Case Details

VAERS ID: 281378 (history)  
Form: Version 1.0  
Age: 15.0  
Gender: Female  
Location: Virginia  
   Days after vaccination:0
Submitted: 2007-06-11
   Days after onset:10
Entered: 2007-06-12
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Grand mal convulsion, Lethargy, Oxygen supplementation, Syncope vasovagal
SMQs:, Torsade de pointes/QT prolongation (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Acute central respiratory depression (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Respiratory failure (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness:
Preexisting Conditions: Absence seizure
Diagnostic Lab Data: none
CDC Split Type: WAES0706USA00635

Write-up: Information has been received from a physician concerning his 15 year old niece, with no known drug allergies and no history of seizures, who on 01-JUN-2007 was vaccinated with Gardasil (lot # 656051/0244U). There was no concomitant medication. On 01-JUN-2007, within 2 to 3 seconds of receiving the first dose of Gardasil, the patient had a vasovagal reaction and sought unspecified medical attention. No laboratory/diagnostic tests were performed. The fainting lasted for 1 to 2 minutes and then she had a tonic clonic seizure that lasted 4 to 5 seconds. The patient was lethargic for about 1/2 hour. The patient was given oxygen and pulse ox. On 01-JUN-2007, the patient recovered from vasovagal reaction and tonic clonic seizure. The physician considered one or more of the events to be disabling and/or an other important medical event. Additional information has been requested.

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