National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 383291

Case Details

VAERS ID: 383291 (history)  
Age: 12.0  
Gender: Female  
Location: Unknown  
Vaccinated:2008-08-26
Onset:2008-09-13
   Days after vaccination:18
Submitted: 2010-03-22
   Days after onset:555
Entered: 2010-03-23
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0523U / - UN / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2429AA / - UN / UN
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52Z015AA / - UN / UN
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0512X / - UN / UN

Administered by: Public       Purchased by: Other
Symptoms: Chronic fatigue syndrome, Condition aggravated, Depression, Migraine, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Depression (excl suicide and self injury) (narrow), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: FLORINEF; PREVACID; TOPAMAX
Current Illness: Neurocardiogenic syncope; Helicobacter pylori infection; Irritable bowel syndrome; Asthma; Prophylaxis
Preexisting Conditions:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES1003USA01956

Write-up: Initial and follow up information has been received from a office medical assistant concerning her 12 year old daughter with no known drug allergies, neurocardio syncope since the 5th grade, Helicobacter pylori, irritable bowel syndrome and asthma who on 26-AUG-2008 (also reported 13-AUG-2010) was vaccinated with a dose of GARDASIL (Lot#657868/0523U) and VARIVAX (Oka/Merck) (Lot#660944/0512X) at a county health. Concomitant vaccination included MENACTRA and BOOSTRIX. Other concomitant therapy included FLORINEF, TOPAMAX and PREVACID. On 13-SEP-2008 the patient experienced chronic fatigue syndrome. Then the patient''s neurocardio syncope was exacerbated leading to migraine headaches and was hospitalized twice in 2008, for an unspecified amount of time. On an unspecified date, the patient was seen by psych who said that the patient was depressed and brought on her own headaches. The reporter stated that this was not true. The patient had been followed by neurology for her neurocardio syncope. It was noted that the patient has been home schooled since 2009, since her conditions keep her from going to school. At the time of the report, the patient had not recovered. Therapy with GARDASIL was discontinued. Chronic fatigue syndrome, exacerbated neurocardio syncope, migraine headaches and depressed were considered to be disabling by the office medical assistant. Additional information has been requested.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=383291


Copyright © 2017 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166