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This is VAERS ID 294682

Case Details

VAERS ID: 294682 (history)  
Form: Version 1.0  
Age: 14.0  
Sex: Female  
Location: Michigan  
Vaccinated:2007-09-13
Onset:2007-09-13
   Days after vaccination:0
Submitted: 2007-10-29
   Days after onset:46
Entered: 2007-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0245U / 1 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2339AA / 1 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52BO12AA / UNK RA / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Aggression, Mental status changes
SMQs:, Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (narrow), Cardiomyopathy (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: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Received HPV #1 vaccine 9/13/07. Mother called on 10/29/07 stating since vaccine given, child''s "mental state altered greatly. All of a sudden she became this witch." Since then "she became very aggressive and almost pouty in every situation". She states that the child hit her (the mother) last Wednesday or Thursday. Mother states that since the shot the child "has become aggressive, dark, argumentative". She further states that since the shot the child has become "mouthy to the teachers". She has always been a "spirited child" according to the mother. Mother now states that the child seems to be calming down some. I offered to submit a VAERS report and mother agreed that I should do so.


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