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This is VAERS ID 449331

Case Details

VAERS ID: 449331 (history)  
Age: 14.0  
Gender: Male  
Location: Pennsylvania  
Vaccinated:2011-12-22
Onset:2011-12-29
   Days after vaccination:7
Submitted: 2012-02-09
   Days after onset:42
Entered: 2012-02-10
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (AFLURIA) / CSL LIMITED UH469AH / 2 UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1359AA / 0 RA / UN

Administered by: Other       Purchased by: Other
Symptoms: Activities of daily living impaired, Asthenia, Blood test, Hypersomnia, Injection site erythema
SMQs:, Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Depression (excl suicide and self injury) (broad)

Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Penicillin allergy
Preexisting Conditions:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES1202USA00177

Write-up: Information has been received from a patient''s mother concerning her 14 year old son with a drug reaction/allergy to penicillin who on 22-DEC-2011, was vaccinated with a dose of GARDASIL (Lot#, dose and route not reported). Secondary suspect therapy included unspecified flu vaccine (manufacturer unknown) administered the same night. About a week after injection, on approximately 29-DEC-2011, the patient experienced asthenia and developed red spots at the injection site. The mother stated that her son has missed a month of school because of the reaction. The patient sought unspecified medical attention. No treatment for the AEs was given. The patient had blood tests performed (results not reported). At the time of the report, the patient had not recovered. Follow up information was received from a registered nurse who stated that the male child was still having difficulties. The child was sleeping up to 20 hours a day. The nurse reported that the patient received only one dose of GARDASIL (Lot#, dose and route not reported). At the time of the report, the patient had not recovered. Asthenia, red spot at the injection site and sleeping up to 20 hours a day were considered to be disabling. Additional information has been requested.


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