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This is VAERS ID 339589

Case Details

VAERS ID: 339589 (history)  
Form: Version 1.0  
Age: 12.0  
Gender: Female  
Location: North Carolina  
   Days after vaccination:16
Submitted: 2009-02-14
   Days after onset:164
Entered: 2009-02-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Unknown       Purchased by: Unknown
Symptoms: Activities of daily living impaired, Convulsion, Hepatobiliary scan, Irritable bowel syndrome, Laboratory test, Nausea, Oesophagogastroduodenoscopy, Pain, Streptococcus identification test negative, Vaccine positive rechallenge
SMQs:, Acute pancreatitis (broad), Systemic lupus erythematosus (broad), Dementia (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Generalised convulsive seizures following immunisation (narrow), Noninfectious diarrhoea (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: None. Seen 2/4/08 for c/o congestion, H/A, fever and abd pain. Assess: Sinustis. Vax given.
Preexisting Conditions: None PMH: none
Diagnostic Lab Data: Large battery of tests performed by Medical Center . Labs and diagnostics: Duodenal bx (-). Stomach bx (+) for chronic gastritis. Esophagus bx (-). H. pylori (-). Biliary patency study WNL. KUB (+) for moderate stool burden. Labs: Strep (-). KUB WNL. Hemoccult (-). ABd US WNL. HIDA scan (+) for biliary dyskinesia-no obstruction. Stool studies (-). EGD (+) for gastric erosions. AST 10. ALT 24. Amylase 21 (L), repeat 39 WNL.
CDC Split Type:

Write-up: Patient given 1st dose of Gardasil Lot # 14484 on 2/4/08. Patient became ill with Severe Adominal Pain and Nausea. Patient given 2nd dose of Gardasil Lot # 17574 on 4/16/08. Patient because ill with Severe adominal pain, and Nausea and treated at pediatricans office on 5/1/08. Patient given 3rd dose of Gardasil Lot # 0067X on 8/18/08. Patient returned to Pediatrician on 9/3/08 with Severe adominal pain, severe nausea, and brain freezes or seizure complaints. Since September of 2008, patient has been placed on a modified school schedule and is being treated by Hospital with little to no improvement. Student is unable to attend school except for an average of 2 days per week. Student has become disabled because of pain, nausea, and seizure effects. 2/19/2009 MR received from PCP which include multiple consults and ER visits. Seen 2/4/08 for c/o congestion, H/A, fever and abd pain. Assess: Sinustis. Vax given. WCC 4/16/08 with normal G&D. PE WNL. Vax given. Returned 5/1/08 with c/o fever, diarrhea, decreased appetitie and po intake. Assess: Pharyngitis. Viral syndrome. OV 6/4/09 for nausea and migraine. Assess: VGE. OV 9/3/08 for H/a, nausea, stomach pain. Assess: VGE. Returned 9/15/08 with RUQ pain and diarrhea. Rx: Prilosec. Similar sx 9/22/08, 9/25/08 with fever. Seen 11/10/08 with for daily "brain freeze'' where pt can''t think clearly, panics, with H/A after. Missed 20 days of school this yr. Sx continue to present. Referred to GI 10/6/08 with multiple consults for abd pain with no clear dx-likely functional. Depression noted 1/13/09. Weight gain 2'' to eating to lessen pain. IBS dx 2/16/09 2/26/09 Hospital records received for ER visit 9/29/08 and later diagnostic studies with DX: Abdominal pain. Pt presented with several week hx of RUQ abdominal cramping with nausea. Severity 4-9/10. PE WNL. Referred for out pt tx. Follow-up: I have reported my daughter''s adverse effects to GARDASIL and so far, she hasn''t shown up in your VAERS database. The # assigned was 339589. Can you let me know if you need anything else from me and/or how long it will take before I can query on her information. I also want to ensure that all 3 of her lots are listed. See below: Below is her lot information and # of VAERS reports of each. Shot 1 - 78 events with Vaccine is ''HPV4'' and Lot Number contain ''1448U''. Shot 2 - 70 events with Vaccine is ''HPV4'' and Lot Number contain ''1757U''. Shot 3 - 74 events with Vaccine is ''HPV4'' and Lot Number contain ''0067X''. All of her lots have had multiple adverse effects listed. Can you make sure this is recorded and let me know when her information will be published for query purposes? Thanks for providing this service.

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