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This is VAERS ID 647241

Case Details

VAERS ID: 647241 (history)  
Age: 11.0  
Gender: Male  
Location: Alabama  
Vaccinated:2012-02-21
Onset:2012-04-30
   Days after vaccination:69
Submitted: 2016-08-10
   Days after onset:1563
Entered: 2016-08-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1524AA / 0 LA / IM

Administered by: Private       Purchased by: Other
Symptoms: Dementia, Generalised tonic-clonic seizure
SMQs:, Systemic lupus erythematosus (broad), Dementia (narrow), 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? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data: Diagnosed with Gen Tonic/Clonic Epilepsy; Major Neurocog D/O with Exec Def
CDC Split Type:

Write-up: Generalized Tonic/Clonic Seizures. Major Neurocognitive D/O with executive Deficits. Takes medication daily.


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