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This is VAERS ID 678231

Case Details

VAERS ID: 678231 (history)  
Age: 13.0  
Gender: Female  
Location: California  
Vaccinated:2008-08-05
Onset:2008-08-05
   Days after vaccination:0
Submitted: 2017-01-16
   Days after onset:3086
Entered: 2017-01-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0571X / 1 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0537X / 1 LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Abdominal pain upper, Altered state of consciousness, Cardiac disorder, Dizziness, Headache, Heart rate increased, Nausea, Pyrexia, Systemic lupus erythematosus
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None but when it was administered patient had to stay in the doctor''s office because she almost passed out and felt nauseated. She developed a fever and severe stomach pain and severe headache.
Preexisting Conditions: None
Diagnostic Lab Data: Patient has developed systemic lupus and problems with rapid heard rate. She has had ongoing problems since the day of the immunization.
CDC Split Type:

Write-up: Felt nauseated, dizzy, severe headache, severe stomach ache, fever. Since that time patient developed lupus and problems with her heart.


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