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This is VAERS ID 381837

Case Details

VAERS ID: 381837 (history)  
Form: Version 1.0  
Age: 14.0  
Gender: Female  
Location: Texas  
   Days after vaccination:249
Submitted: 2010-03-03
   Days after onset:579
Entered: 2010-03-04
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Gait disturbance, Laboratory test normal, Muscular weakness, Myalgia, Oedema peripheral, Pain in extremity, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Tendinopathies and ligament disorders (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: albuterol; PREVACID; SINGULAIR
Current Illness: Asthma; Bronchitis
Preexisting Conditions: Gastrointestinal pain; Gastrooesophageal reflux
Diagnostic Lab Data: diagnostic laboratory, negative
CDC Split Type: WAES1002USA03728

Write-up: Information has been received from an office Manager concerning a 15 year old female with asthma and bronchitis, and a history of upper gastrointestinal pain and reflux, and no known allergies, who on 26-NOV-2007 was vaccinated with the first standard dose of GARDASIL, IM. The vaccination dates of the second dose and the third dose were not reported. Concomitant therapy included montelukast sodium, albuterol and PREVACID. In August 2008, after completing the GARDASIL series the patient experienced general muscle weakness, muscle pain, leg pain, leg swelling and syncope. The patient had difficulty walking due to the leg swelling. She sought medical attention via office visit. The patient was hospitalized, but reporter did not know how long the patient was hospitalized. Lab and Diagnostic Studies were done but the Office worker did not know exactly what studies were completed. Patient was seen by Cardiology and Neurology Specialist for intervention to to prevent serious criteria and all findings so far were negative. It was reported that the patient was still following up with various physicians and did not know if the symptoms had resolved at this time. General muscle weakness, muscle pain, leg pain, leg swelling, syncope and difficulty walking were considered to be other important medical events. Leg swelling and difficulty walking were considered to be disabling by the reporter, since the patient had difficulty walking due to the leg swelling. Additional information has been requested.

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