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This is VAERS ID 521163

Case Details

VAERS ID: 521163 (history)  
Form: Version 1.0  
Age: 15.0  
Sex: Female  
Location: Texas  
Vaccinated:2014-01-22
Onset:2014-01-24
   Days after vaccination:2
Submitted: 2014-01-27
   Days after onset:3
Entered: 2014-01-29
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. J012212 / 2 LA / UN

Administered by: Private       Purchased by: Private
Symptoms: Convulsion
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Prematurity; E1A
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Received phone call from patient''s mother on 1/27/14 at 11:45am that child was awakened from sleep 1/24/14 having a seizure. Received notification from ER 1/28/14 that child had been admitted for evaluation of seizure.


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