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This is VAERS ID 413712

Case Details

VAERS ID: 413712 (history)  
Form: Version 1.0  
Age: 11.0  
Gender: Female  
Location: Wisconsin  
Vaccinated:2009-10-02
Onset:2009-10-02
   Days after vaccination:0
Submitted: 2010-12-29
   Days after onset:453
Entered: 2010-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0604Y / 1 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0653X / 1 RA / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U3058AA / 1 RA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR UF471CA / 1 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1537Y / 2 RA / IM

Administered by: Unknown       Purchased by: Private
Symptoms: Acne, Convulsion, Electroencephalogram abnormal, Epilepsy, Headache, Hypoaesthesia facial, Loss of consciousness, Paraesthesia
SMQs:, Torsade de pointes/QT prolongation (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? Yes
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: Following hpv vaccine (along with meningitis shot) my daughter started having black out episodes later EEG results came back abnormal indicating seizure / epilepsy which she NEVER had before. Other neurological symptoms include: frequency of episodes getting progressively more often, Occasional numbness of face Tingling of arms head aches following seizures also bad acne
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Following hpv vaccine (along with meningitis shot) my daughter started having black out episodes later EEG results came back abnormal indicating seizure / epilepsy which she NEVER had before. Other neurological symptoms include: frequency of episodes getting progressively more often, Occasional numbness of face Tingling of arms head aches following seizures


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