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This is VAERS ID 485513

Case Details

VAERS ID: 485513 (history)  
Age: 11.0  
Gender: Male  
Location: New Jersey  
Vaccinated:2011-10-03
Onset:2011-11-06
   Days after vaccination:34
Submitted: 2013-02-05
   Days after onset:457
Entered: 2013-02-25
   Days after submission:20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0692AA / - UN / SYR
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR M10126A / - UN / UN
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C3518AA / - UN / UN

Administered by: Private       Purchased by: Unknown
Symptoms: Amnesia, Convulsion, Epilepsy, Fear, Personality change
SMQs:, Systemic lupus erythematosus (broad), Dementia (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Epilepsy as a result of vaccination
CDC Split Type:

Write-up: Seizures started 2 weeks after the shot. Personality changed. Patient felt scared. Loss of memory. Taking zonisamide 6 pills a day to control seizures.


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