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This is VAERS ID 493099

Case Details

VAERS ID: 493099 (history)  
Age: 11.0  
Gender: Female  
Location: Ohio  
Vaccinated:2012-08-20
Onset:2012-08-29
   Days after vaccination:9
Submitted: 2013-06-03
   Days after onset:278
Entered: 2013-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1167Z / 0 AR / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR U4046AA / 0 AR / IM

Administered by: Public       Purchased by: Other
Symptoms: Abasia, Abnormal behaviour, Activities of daily living impaired, Amnesia, Convulsion, Dizziness, Dyskinesia, Encephalitis autoimmune, Guillain-Barre syndrome, Pain, Speech disorder, Syncope, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Convulsions (narrow), Dyskinesia (narrow), Dystonia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (narrow), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Cardiomyopathy (broad), Demyelination (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 58 days
   Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: None
Current Illness: No she was a healthy kid
Preexisting Conditions: None
Diagnostic Lab Data: Anti-NMDA receptor encephalitis she can''t rememeber how to spell, math. She can''t get some of her words out she has seizures and she had Guillain Barre syndrome.
CDC Split Type:

Write-up: Vomiting dizzy fainting jerking on right side in pain then she couldn''t hardly speak acting crazy at times couldnt walk or feed herself. She got anti-NMDA receptor encephalitis from it and seizures and she Guillain Barre syndrome.


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