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This is VAERS ID 582197

Case Details

VAERS ID: 582197 (history)  
Age: 12.0  
Gender: Female  
Location: Oklahoma  
Vaccinated:2012-09-19
Onset:2014-10-18
   Days after vaccination:759
Submitted: 2015-06-16
   Days after onset:241
Entered: 2015-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB642C / 1 RA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0555AE / 0 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U4289AA / 0 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B093B / 6 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. H009738 / 1 LA / SC

Administered by: Private       Purchased by: Other
Symptoms: Computerised tomogram, Electroencephalogram, Generalised tonic-clonic seizure, Laboratory test, Nuclear magnetic resonance imaging
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? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Mri eeg ct scans labs
CDC Split Type:

Write-up: Tonic clonic seizure.


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