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This is VAERS ID 625301

Case Details

VAERS ID: 625301 (history)  
Form: Version 1.0  
Age: 16.0  
Gender: Female  
Location: Colorado  
Submitted: 2016-03-04
Entered: 2016-03-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Computerised tomogram head abnormal, Electroencephalogram abnormal, Generalised tonic-clonic seizure, Mental impairment, Nuclear magnetic resonance imaging brain abnormal, Seizure
SMQs:, Systemic lupus erythematosus (broad), Dementia (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data: Computerised tomogram, mentally challenged; Electroencephalogram, mentally challenged; Nuclear magnetic resonance imaging, mentally challenged
CDC Split Type: WAES1603USA001499

Write-up: Information has been received from a consumer referring to her 16 years old daughter. The patient was not pregnant. The patient had no medical history and drug reactions or allergies. On an unknown date in 2011, the patient was vaccinated with her first dose of GARDASIL (0.5 ml, lot # and expiry date unknown, intramuscular). There was no concomitant therapy reported. In 2011, almost immediately following her first intramuscular injection, the patient experienced grand mal seizures. The patient''s mother also noticed at that time that her daughter''s mental acumen began declining (The patient was previously an honor student in school). On unknown dates, the patient was vaccinated with her second and third dose of GARDASIL (0.5 ml, lot # and expiry date unknown, intramuscular). On an unknown date, the patient''s mother took the patient to a neurologist who ran a battery of tests including electroencephalogram (EEG), nuclear magnetic resonance imaging (MRI) and computerised tomogram (CAT scan). Subsequently, the test results determined the patient was "mentally challenged". In September 2014, the patient was hospitalized at a hospital for 2 days due to severe seizures (started in September 2014). The patient was also prescribed TEGRETOL (generic) by the neurologist to lessen seizures. The patient''s mother also stated that the patient was still suffering from severe seizures. The outcome of grand mal seizures, mental acumen decline and "mentally challenged" was unknown. Causality was not provided. The events were considered to be disabling by the reporter. Upon internal review, the severe seizures and grand mal seizures were determined to be medically significant. Additional information has been requested.

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