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This is VAERS ID 532797

(NOTE: This result is from the 10/14/2018 version of the VAERS database)

Case Details

VAERS ID: 532797 (history)  
Form: Version 1.0  
Age: 12.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2007-10-02
Onset:2007-11-14
   Days after vaccination:43
Submitted: 2014-05-02
   Days after onset:2360
Entered: 2014-06-03
   Days after submission:32
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0181U / 1 LA / IM

Administered by: Public       Purchased by: Unknown
Symptoms: Computerised tomogram head normal, Convulsion, Death, Electrocardiogram normal, Electroencephalogram abnormal, Full blood count normal, Liver function test normal, Nuclear magnetic resonance imaging brain abnormal, Pineal gland cyst
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? No
Birth Defect? No
Died? Yes
   Date died: 2014-01-11
   Days after onset: 2250
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: ECG = normal sinus rhythm, normal ECG; Head MRI - Pineal cyst (6mm); Head CT - no evidence of acute intracranial abnormalities
CDC Split Type:

Write-up: 11/14/2007 - Seizure. Confirmed by EEG. Begun using DEPAKOTE. CBC and LFT''s - within nml limits.


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