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This is VAERS ID 555257

Case Details

VAERS ID: 555257 (history)  
Age: 13.0  
Gender: Female  
Location: Illinois  
Vaccinated:2012-01-03
Onset:2012-11-01
   Days after vaccination:303
Submitted: 2014-11-23
   Days after onset:752
Entered: 2014-11-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1359AA / 2 LA / IM

Administered by: Unknown       Purchased by: Private
Symptoms: Anxiety, Concussion, Convulsion, Depression, Head injury, Neurological symptom, Panic attack, Postural orthostatic tachycardia syndrome, Syncope, Tachycardia, Tremor
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Depression (excl suicide and self injury) (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations: Swelling, Itching~Influenza (Seasonal) (no brand name)~1~14.92~Patient
Other Medications: None
Current Illness: No
Preexisting Conditions: Allergic to Eggs & Sulfa Meds
Diagnostic Lab Data:
CDC Split Type:

Write-up: Panic Attacks, Tachycardia. Syncope, Head Injuries, Concussions. Seizures. Convulsions. POTS (Postural Orthostatic Tachycardia Syndrome). Depression. Anxiety. Neurological Problems. Tremors.


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