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This is VAERS ID 282216

Case Details

VAERS ID: 282216 (history)  
Form: Version 1.0  
Age: 18.0  
Gender: Female  
Location: Pennsylvania  
Vaccinated:2007-06-04
Onset:2007-06-04
   Days after vaccination:0
Submitted: 2007-06-18
   Days after onset:14
Entered: 2007-06-19
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR - / UNK UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Grand mal convulsion, Loss of consciousness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), 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? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC Split Type: WAES0706USA01993

Write-up: Information has been received from a physician concerning an 18 year old female with no pertinent medical history who on 04-JUN-2007 received her first dose of Gardasil concomitantly with a dose of Menactra. After administration of the Gardasil on 04-JUN-2007, the patient fainted, was unconscious for 45-60 seconds and exhibited tonic-clonic seizure-like activity. There were no laboratory tests performed. She sought unspecified medical attention. No treatment was required. The patient left the office fully recovered. Upon internal review, tonic-clonic seizure-like activity was considered to be an other important medical event. Additional information has been requested.


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