National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 539967

Case Details

VAERS ID: 539967 (history)  
Age: 11.0  
Gender: Female  
Location: Michigan  
Vaccinated:2012-06-29
Onset:2012-06-29
   Days after vaccination:0
Submitted: 2014-08-15
   Days after onset:777
Entered: 2014-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0963AA / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U4246AA / 1 LA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C4181AA / 6 RA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0573AA / 2 LA / IM

Administered by: Private       Purchased by: Other
Symptoms: Abnormal behaviour, Back pain, Blood test, Breath holding, Electroencephalogram abnormal, Nuclear magnetic resonance imaging, Pain in extremity
SMQs:, Retroperitoneal fibrosis (broad), Dementia (broad), Acute central respiratory depression (narrow), Psychosis and psychotic disorders (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Hostility/aggression (broad), Respiratory failure (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, 11 days
   Extended hospital stay? No
Previous Vaccinations: 6/29/2012~HPV (Gardasil)~1~11.17~Patient|strange staring spells~HPV (Gardasil)~1~11.25~Patient
Other Medications: None
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data: Jan 4 2013 MRI EEG; Feb 2013 Extended EEG stay in hospital; Jan 2 2013 Blood work; August 2013 emergency hospital stay; Feb 18 2014 Extended EEGg hospital stay
CDC Split Type:

Write-up: Complained her back hurt and her legs hurt. Gave Motrin then a few weeks later noticed strange activity. In December noticed she was holding her breath during this strange activity. Contacted doctor and they ordered eeg and mri eeg showed activity. Referred to neurologist.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=539967


Copyright © 2017 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166