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This is VAERS ID 291023

(NOTE: This result is from the 2/14/2018 version of the VAERS database)

Case Details

VAERS ID: 291023 (history)  
Form: Version 1.0  
Age: 18.0  
Sex: Female  
Location: Pennsylvania  
   Days after vaccination:6
Submitted: 2007-08-29
   Days after onset:14
Entered: 2007-09-10
   Days after submission:12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Private       Purchased by: Other
Symptoms: Blood thyroid stimulating hormone, Fatigue, Full blood count, Hypoaesthesia, Laboratory test, Paraesthesia, Red blood cell sedimentation rate
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: The patient had been vaccinated with Gardasil on 24 July 2007. The patient had no relevant medical history and no illness at the time of vaccination.
Diagnostic Lab Data: 15 August 2007-CBC, Sed rate, BMP, TSH, Lyme titer. Results pending.
CDC Split Type: 200702813

Write-up: An 18-year-old female patient with no relevant medical history, had received an intramuscular intramuscular left arm injection of Menactra, lot number U2393BA on 09 August 2007 and six days later complained of fatigue and numbness and tingling in her hands and feet. The patient had also received an intramuscular left deltoid injection of Gardasil (Merck), lot number 0525U on 24 July 2007. The patient had not received any concomitant medications, had no relevant medical history and had not been ill at the time of vaccination. The reporter stated that the patient had received a meningococcal immunization one year ago, however the specific vaccine was unknown at the time of the report. The reporter did not indicate any prior events had occurred. On 15 August 2007, six days after she had received the vaccine, the patient complaint of fatigue and numbness and tingling in her hands and feet. Laboratory testing had been performed 15 August 2007 which included CBC, Sed rate, BMP, TSH, and Lyme titer. All laboratory results had been pending. The reporter indicated that the patient had not yet been evaluated by their physician. No further information has been provided. At the time of the report, the patient had not recovered from the event.

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