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This is VAERS ID 324292

Case Details

VAERS ID: 324292 (history)  
Form: Version 1.0  
Age: 15.0  
Gender: Female  
Location: Delaware  
Vaccinated:2007-11-19
Onset:2007-11-20
   Days after vaccination:1
Submitted: 2008-08-29
   Days after onset:282
Entered: 2008-09-05
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR UT2458BA / 6 RA / SC
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1266U / 1 LA / UN

Administered by: Private       Purchased by: Private
Symptoms: Arthralgia, Headache, Immediate post-injection reaction, Lethargy, Malaise
SMQs:, Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypersensitivity (narrow), Arthritis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: N/A
Preexisting Conditions: None PMH: cupping of optic disc. Eye itch & burn. Hypermetropia, painful menses, using contraception to regulate. Excision of chalazia bilateral lower eyelids. Adopted. Family hx cancer. HPV #2 given 1/29/08, Lot # 1265U; HPV #3 given 6/10/08, Lot # 1757Y, RA.
Allergies:
Diagnostic Lab Data: Eye exams (2 different Opt.)
CDC Split Type:

Write-up: Severe headaches (immed. after 1st course) continuing almost daily. Joint aches, extreme malaise and lethargy. (2 visits to eye specialist - reported to physician). 9/23/08 Reviewed PCP medical records & vaccine records. PCP office called parent for status check as they were unaware of any problems patient had. Office states patient had severe HA after 1st & 3rd HPV vaccines. Parent reports patient is completely asymptomatic now. Eye exam of 12/31/07 reveals clear vision & no pain. 1/26/2010 Headaches have lessend but still occurring.


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