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This is VAERS ID 467018

Case Details

VAERS ID: 467018 (history)  
Form: Version 1.0  
Age: 12.0  
Gender: Female  
Location: North Carolina  
   Days after vaccination:118
Submitted: 2012-09-29
   Days after onset:394
Entered: 2012-10-01
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Private       Purchased by: Other
Symptoms: Abdominal discomfort, Antinuclear antibody, Blood creatine phosphokinase, Blood test, Blood thyroid stimulating hormone, Convulsion, Decreased appetite, Electroencephalogram normal, Full blood count, Insomnia, Muscular weakness, Red blood cell sedimentation rate, Syncope, Thyroxine free, Tremor, Urine analysis, Weight decreased
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Parkinson-like events (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (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:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: EEG normal; Just did blood/urine test; CBC; TSH; Free T4; CPK; ANA; Sed rate; U/A; results not in yet
CDC Split Type:

Write-up: Seizures. Fainting. Lack of appetite. Insomnia. Weight loss. Muscle weakness. Upset stomach. Shaky hands. Patient is seeing an adolescent Neurologist.

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