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This is VAERS ID 380740

Case Details

VAERS ID: 380740 (history)  
Form: Version 1.0  
Age: 13.0  
Gender: Female  
Location: Washington  
Vaccinated:2009-08-25
Onset:2009-10-01
   Days after vaccination:37
Submitted: 2010-02-18
   Days after onset:140
Entered: 2010-02-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUN3: INFLUENZA (SEASONAL) (FLUMIST) / MEDIMMUNE VACCINES, INC. 500673P / UNK NS / IN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0671Y / 1 AR / IJ

Administered by: Private       Purchased by: Other
Symptoms: Death, Decreased activity, Fall, Headache, Hypoaesthesia, Loss of control of legs, Menstruation irregular, Oedema peripheral, Paraesthesia, Peripheral coldness, Sensory loss, Unresponsive to stimuli
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Fertility disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2009-10-17
   Days after onset: 16
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Trileptol and Keppra
Current Illness: My daughter had a seizure disorder that came on with her periods.
Preexisting Conditions: Patient had a pre-existing seizure disorder which she was on trileptol and Keppra to control the seizures.
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received the HPV as well as the flu nasal spray on Aug 25th. I first declined getting her the vaccination but her doctor ensured me that it was safe. I had declined the same vaccination a year earlier at the downtown public health center. Patient was getting ready for school and was standing by her closet, and all of a sudden she fell, she lost total control of her legs. She went to school and could not engage in any of the activities because of the numbness in her legs and the swelling of her foot. She also, started to get a really bad headache. Days later she woke up out of her sleep complaining of a severe headache, which usually she gets if she has a seizure but she hadn''t had a seizure this night. She continued to say she had not feeling in her foot and tingling feeling in her leg. After I examined her foot I noticed it was swollen. The next morning I called her doctors office and made her doctors appointment for Oct 23rd. During the month of October she had irregular periods. My daughter never made it to Oct 23rd, which as also her birthday. She passed on Oct. 17th, I found her cold unresponsive in her room at 7am, which I went in to wake her up to take her morning pills.


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