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This is VAERS ID 577937

Case Details

VAERS ID: 577937 (history)  
Form: Version 1.0  
Age: 11.0  
Gender: Female  
Location: Arizona  
Vaccinated:2010-06-25
Onset:2013-05-01
   Days after vaccination:1041
Submitted: 2015-05-06
   Days after onset:735
Entered: 2015-05-13
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1013Y / 1 RA / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U3077AA / 1 RA / UN
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC5B040BA / 1 LA / UN
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1594Y / 2 UN / SC

Administered by: Private       Purchased by: Private
Symptoms: Computerised tomogram, Electroencephalogram abnormal, Epilepsy, Hypometabolism, Nausea, Nuclear magnetic resonance imaging, Positron emission tomogram, Seizure, Vomiting
SMQs:, Acute pancreatitis (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (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, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: MRI, CT, PET scan, EEGs-hypometabolic (R) hemisphere intractable epilepsy
CDC Split Type:

Write-up: After last HPV had ongoing nausea and vomiting for over 6 months. Had 1st seizure May 2013. Seizures have continued. Normal development milestones with above avg intelligence.


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