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This is VAERS ID 308597

Case Details

VAERS ID: 308597 (history)  
Form: Version 1.0  
Age: 15.0  
Gender: Female  
Location: Maryland  
Vaccinated:2007-07-23
Onset:2007-09-04
   Days after vaccination:43
Submitted: 2008-03-28
   Days after onset:206
Entered: 2008-03-31
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0171U / 1 UN / UN

Administered by: Private       Purchased by: Public
Symptoms: Influenza like illness, Lumbar puncture, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (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: LAMICTAL
Current Illness: Convulsion disorder; Petit mal
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: spinal tap, 09/04?/07
CDC Split Type: WAES0803USA01553

Write-up: Initial and follow up information has been received from a physician concerning a 15 year old female patient with a seizure disorder of petit mal convulsions, who was vaccinated on 23-JUL-2007, with her first dose of Gardasil (lot# 655620/0171U). Concomitant therapy included LAMICTAL. On 04-SEP-2007, at 10:10 am, the patient experienced flu-like symptoms and myalgia. The patient sought medical treatment, and a lumbar puncture was performed (results not specified). Treatment included MOTRIN, 800mg, STAT, diazepam and LORTAB. On 18-OCT-2007, the events resolved. Physician decided to discontinue the series with Gardasil. The physician considered the events serious as persistent/significant disability or incapacity. Additional information is not expected. Additional information has been requested.


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