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This is VAERS ID 307627

Case Details

VAERS ID: 307627 (history)  
Form: Version 1.0  
Age: 16.0  
Gender: Female  
Location: Delaware  
   Days after vaccination:27
Submitted: 2008-03-19
   Days after onset:15
Entered: 2008-03-21
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Abdominal pain upper, Activities of daily living impaired, Epstein-Barr virus antibody negative, Fatigue, Hyperhidrosis, Splenomegaly, Ultrasound abdomen abnormal
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: ultrasound slightly enlarged spleen; serum Epstein-Barr negative
CDC Split Type: WAES0803USA02393

Write-up: Information has been received from a physician concerning a 16 year old female who on 05-FEB-2008 was vaccinated with Gardasil (lot number not provided). On 03-MAR-2008 the patient experienced extreme fatigue, severe stomach pains and breaking out in sweat. The patient also stated "the pain is so extreme, she can not go to school." The patient''s extreme fatigue and severe stomach pains and breaking out in sweat persisted. On an unspecified date, the patient had a mononucleosis test performed-result was negative. On an unspecified date an ultrasound was also performed, results indicated that the patients spleen was slightly enlarged. Extreme fatigue, severe stomach pains and breaking out in sweat were considered to be disabling. Additional information has been requested.

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