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This is VAERS ID 299724

Case Details

VAERS ID: 299724 (history)  
Form: Version 1.0  
Age: 14.0  
Gender: Female  
Location: Tennessee  
Vaccinated:2007-09-27
Onset:2007-09-27
   Days after vaccination:0
Submitted: 2007-11-14
   Days after onset:48
Entered: 2007-11-15
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. UNK / 1 UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Guillain-Barre syndrome
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Demyelination (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0710USA05575

Write-up: Information has been received from a physician concerning a 14 year old female with no pertinent medical history or drug reaction/allergies, who on 27-SEP-2007 was vaccinated with the first dose of Gardasil vaccine (0.5 mL). There was no concomitant medication. On 27-SEP-2007 the patient experienced Guillain-Barre Syndrome and was hospitalized. Hospitalization time was unknown. No further details were provided. The Guillain-Barre Syndrome was considered to be immediately life-threatening and disabling. At the time of this report, the patient was recovering.


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