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This is VAERS ID 342701

Case Details

VAERS ID: 342701 (history)  
Age: 16.0  
Gender: Female  
Location: Unknown  
Vaccinated:2009-03-12
Onset:2009-03-13
   Days after vaccination:1
Submitted: 2009-03-25
   Days after onset:12
Entered: 2009-03-26
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR - / - UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Blindness, Cyanosis, Deafness, Loss of consciousness, Pallor, Sensation of heaviness, Similar reaction on previous exposure to drug
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Optic nerve disorders (broad), Retinal disorders (broad), Hearing impairment (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: RECLIPSEN; LEXAPRO
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Blood pressure, 03/01?/09, 94/54
CDC Split Type: WAES0903USA02617

Write-up: Information has been received from a physician assistant concerning a 16 year old female with no allergies who on 12-NOV-2008 was vaccinated with the first dose of GARDASIL. On 12-MAR-2009 the patient was vaccinated with the second dose of GARDASIL. Concomitant therapy included MENACTRA on 12-MAR-2009 into opposite arm, LEXAPRO and RECLIPSEN. On 13-MAR-2009, almost exactly 24 hours after administration, she experienced blacking out, legs feeling like "dead weight", her lips turned blue, she had an ashen color to her skin, and she could not see or hear. She visited the physician assistant who admitted her to the hospital. She was given saline and was monitored on telemetry for cardiac function. She also had a CT scan (results not reported). She was discharged after 24 hours. Her blood pressure was 94/54. The patient recovered on an unspecified date. The patient''s mother also told the physician assistant that after the first dose similar symptoms occurred but no black-outs. The symptoms occurred 24 hours after receiving first dose but the patient did not seek medical attention and had recovered. The events occurring 13-MAR-2009 were considered to be disabling. Additional information has been requested.


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