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This is VAERS ID 612719

Case Details

VAERS ID: 612719 (history)  
Age: 16.0  
Gender: Female  
Location: Puerto Rico  
Vaccinated:2013-08-19
Onset:2013-11-25
   Days after vaccination:98
Submitted: 2015-11-23
   Days after onset:728
Entered: 2015-12-02
   Days after submission:9
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS 5J5HT / 0 UN / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. J006236 / 2 UN / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO) / NOVARTIS VACCINES AND DIAGNOSTICS M12092 / 0 UN / IM

Administered by: Private       Purchased by: Private
Symptoms: Brain neoplasm, Brain stem glioma, Computerised tomogram, Death, Dizziness, Malaise, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Non-haematological malignant tumours (narrow), Non-haematological tumours of unspecified malignancy (narrow)

Life Threatening? No
Died? Yes
   Date died: 2014-06-18
   Days after onset: 204
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Asthma
Diagnostic Lab Data: She receive MENACTRA vaccine in 2/25/2009 and FLUZONE in 10/03/2013
CDC Split Type:

Write-up: In 10/2013 she said I don''t fell well, I have something in my head. She have CT scan, but in 11/25/2013 she awoke with nausea, dizzy she get another CT scan. But on January 13, 2014 I bring her E.R. in Hospital and they Dx with Pontine Glioma Tumor Brain.


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