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This is VAERS ID 289026

Case Details

VAERS ID: 289026 (history)  
Form: Version 1.0  
Age: 16.0  
Gender: Female  
Location: Unknown  
Vaccinated:2007-08-01
Onset:2007-08-01
   Days after vaccination:0
Submitted: 2007-08-24
   Days after onset:23
Entered: 2007-08-27
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / IM

Administered by: Other       Purchased by: Other
Symptoms: Grand mal convulsion, Head injury, Heart rate, Heart rate decreased, Hyperhidrosis, Syncope vasovagal, Tonic clonic movements
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: total heartbeat count 08/01/07 43 BPM - PV; total heartbeat 08/01/07 68 BPM - 20 min PV
CDC Split Type: WAES0708USA03395

Write-up: Information has been received from a physician concerning a 16 year old female with no known allergies who on 01-AUG-2007 was vaccinated with the first dose of Gardasil (Lot# not provided). No concomitant therapies were reported. The physician reported that within 60 seconds post vaccination the patient had a vasal vagal response, experienced a Tonic clonic Grand mal seizure and hit her head on the office wall. The physician reported that at that time the patient was sweating and her pulse was 43 BPM. The patient laid down and oxygen was administered. The physician reported that the patient was monitored and with 20 minutes her pulse was 68 BPM and she had recovered from the event. The physician considered the event to be disabling and an other important medical event. Additional information has been requested.


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