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This is VAERS ID 325957

Case Details

VAERS ID: 325957 (history)  
Form: Version 1.0  
Age: 10.0  
Gender: Female  
Location: Unknown  
Vaccinated:2007-05-01
Onset:2007-07-01
   Days after vaccination:61
Submitted: 2008-09-23
   Days after onset:450
Entered: 2008-09-24
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Abasia, Antiphospholipid antibodies positive, Convulsion, Nervous system disorder, Pyrexia, Rash, Renal failure, Speech disorder, Systemic lupus erythematosus
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Dementia (broad), Convulsions (narrow), Dystonia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Chronic kidney disease (narrow), Hypersensitivity (narrow), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 69 days
   Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: None
Current Illness: Drug hypersensitivity
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: lupus anticoagulant, 07?/??/08, positive
CDC Split Type: WAES0809USA02640

Write-up: Information has been received from a physician concerning a 10 year old female with CYTOXAN allergy who in May 2007 was vaccinated with the first dose of GARDASIL. In July or August of 2007, the patient was vaccinated with the second dose of GARDASIL. There was no concomitant medication. The patient has not yet received the third dose. The patient first experienced high fever and rash in July 2007. The patient was diagnosed with lupus. She then progressed to having seizures and kidney insufficiency. The patient lost all neurological functions including the ability to walk and talk considered to be disabling. She was hospitalized from 23-NOV-2007 to 30-JAN-2008 until there was some improvement. The patient was given oxygen while in the hospital. The patient still can not walk but able to recover her speech. The patient was considered to be recovering from lupus, seizures and renal insufficiency. Seizures were considered to be immediately life-threatening. Lupus, seizures, loss of ability to walk and talk and kidney insufficiency were considered to be an other important medical events and disabling by the physician. Additional information has been requested.


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