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This is VAERS ID 437141

Case Details

VAERS ID: 437141 (history)  
Form: Version 1.0  
Age: 15.0  
Gender: Female  
Location: Florida  
Vaccinated:2011-08-25
Onset:2011-09-01
   Days after vaccination:7
Submitted: 2011-10-06
   Days after onset:35
Entered: 2011-10-07
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0841AA / 1 UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Abnormal behaviour, Asthenia, Blood test normal, Chest pain, Computerised tomogram normal, Convulsion, Dyskinesia, Dyspnoea, Dysstasia, Grip strength decreased, Head titubation, Laboratory test normal, Nuclear magnetic resonance imaging normal, Tremor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Dementia (broad), Convulsions (narrow), Dyskinesia (narrow), Parkinson-like events (broad), Acute central respiratory depression (broad), Psychosis and psychotic disorders (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hostility/aggression (broad), Cardiomyopathy (broad), Generalised convulsive seizures following immunisation (narrow), 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: None
Current Illness: Hypersensitivity; Heavy periods
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: diagnostic laboratory, 09/??/11, blood work normal; computed axial, 09/26/11, negative; magnetic resonance, 09/26/11, negative
CDC Split Type: WAES1109USA03241

Write-up: Information has been received from a consumer (patient''s mother) and the physician concerning a 15 year old female patient with allergy to BENADRYL, with heavy menses and no medical history who on 25-AUG-2011 (not 16 or 17 days prior to 28-SEP-2011 as reported by consumer), was vaccinated with the first dose of GARDASIL (lot number: 668262/0841AA, route not reported). There was no concomitant medication. Consumer reported that one week after her daughter was vaccinated, she experienced shortness of breath and 14 days after vaccination, she also started to experience "seizures" every 45 minutes. Consumer described the seizures as, "she jumps up and down and her chest hurts". Consumer reported that the seizures lasted for 30 seconds. Consumer also reported that while her daughter was sleeping, she experienced tremors in the legs, arms and head, and that in addition to the seizures, her daughter also felt weak, and she could "barely stand up or hold a pencil". Consumer and the physician reported that the patient went to two different emergency rooms before seeing the reporting physician, and, "the bloodwork is all normal". Physician reported that the patient did not receive any treatment for the adverse events. On 26-SEP-2011, the patient was seen by the reporting physician for the events and it was reported that the physician saw no seizure activity but could confirm tremors and weakness. A computed axial tomography (CT) and magnetic resonance imaging (MRI) were negative. The patient was referred to a pediatric neurologist. Consumer reported that her daughter had an appointment today to see a pediatric neurologist. The reporting physician could not address the life threatening criterion, but did not feel the events were disabling. No inpatient hospital confinement. The physician reported that, the patient had not recovered. Additional information has been requested.


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