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This is VAERS ID 289177

Case Details

VAERS ID: 289177 (history)  
Form: Version 1.0  
Age: 18.0  
Sex: Female  
Location: Florida  
Vaccinated:2007-08-23
Onset:2007-08-23
   Days after vaccination:0
Submitted: 2007-08-27
   Days after onset:4
Entered: 2007-08-28
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1060U / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2381BA / 1 RA / IM

Administered by: Private       Purchased by: Private
Symptoms: Blood pressure, Chills, Condition aggravated, Dyspnoea, Headache, Lumbar puncture, Pain, Photophobia, Pyrexia, Tremor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Glaucoma (broad), Cardiomyopathy (broad), Corneal disorders (broad), Retinal disorders (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? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None records received 9/19/07- CBC unremarkable, BMP also unremarkable, spinal tap within normal limits and culture negative.. Throat culture negative. Blood and urine cultures negative. Echo demonstrated left peripheral pylmonic stenosis benign in nature. CT brain unremarkable.
CDC Split Type:

Write-up: severe headache at night time after vaccination; exacerbated in the next morning, photophobia, entire body ache, chills, trouble breathing, low grade fever 100.3. On exam BP 150/78 shaking but nonconvulsive, transferred to hospital via ambulance. 1 day admission, spinal tap has r/o meningitis done-normal. Persistent headache few days after discharge 9/19/07-records received for DOS /24-/26/07- DC DX: Probable reaction to meningococcal vaccination. Meningitis has been ruled out. Headache and back pain now stable. Headache and back pain is thought to be due to probable reaction to meningococcal vaccination and probably from the spinal tap also. C/O headache and photophobia. Fever of 103 and sore throat for past 24 hours. Associated neck stiffness and pain.


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