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This is VAERS ID 536061

Case Details

VAERS ID: 536061 (history)  
Form: Version 1.0  
Age: 11.0  
Gender: Female  
Location: Michigan  
Vaccinated:2011-08-15
Onset:2011-09-13
   Days after vaccination:29
Submitted: 2014-07-07
   Days after onset:1028
Entered: 2014-07-08
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0841AA / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U4031AA / 1 LA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C3927BA / 6 LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Antinuclear antibody increased, Blood creatine phosphokinase increased, Blood lactate dehydrogenase increased, Dermatomyositis, Fatigue, Immunoglobulin therapy, Muscle contracture, Muscular weakness, Nuclear magnetic resonance imaging abnormal, Rash, X-ray
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (narrow), Myocardial infarction (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 28 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Elevated CK, LDH, ANA; Xrays; MRI - confirmation of dermatomyositis in thighs
CDC Split Type:

Write-up: 9-13-2011 Appearance of "rash" - on face and chest treated with oral steroids and antihistamine. 9-25-2011 Rash still present. Treated with more prednisone. Nov - Dec 2011 - Treated with topicals; Jan 2012 more topicals. June 2012 muscle contractures, rash, fatigue, muscle weakness. July 2012 - Dermatomyositis - prednisone, SOLUMEDROL, IVIG, CELLCEPT.


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