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This is VAERS ID 313383

Case Details

VAERS ID: 313383 (history)  
Form: Version 1.0  
Age: 13.0  
Gender: Female  
Location: Massachusetts  
   Days after vaccination:5
Submitted: 2008-05-23
   Days after onset:296
Entered: 2008-05-27
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Anaemia, Colitis ulcerative, Fatigue, Haematochezia, Laboratory test abnormal
SMQs:, Haematopoietic erythropenia (broad), Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal ulceration (narrow), Gastrointestinal haemorrhage (narrow), Ischaemic colitis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None 6/20/08-records received-Thyroglossal dut cyst status post repair. Minimal GER. Postive ANCA 34.1.
Diagnostic Lab Data: diagnostic laboratory, 01/04?/08, anemia 6/20/08-records received-KUB WNL. CBC and chemistry WNL. Endoscopy:Moderate pancolitis.
CDC Split Type: WAES0805USA03813

Write-up: Information has been received from a physician concerning a 14 year old female patient with no medical history or drug allergies reported, who on 27-JUL-2007, 02-SEP-2007 and 06-FEB-2008 (3rd dose also reported as 27-JUL-2008 administered intramuscularly) was vaccinated with the first, second and third doses of GARDASIL, respectively. There was no concomitant medication. In August 2007, after the physician reviewed the patient''s past medical history, he noticed that the patient experienced bloody stools in the beginning of August 2007 after her first dose of GARDASIL. On 04-JAN-2008 the patient saw her physician and stated that she was experiencing constant fatigue and tiredness. A blood test was taken and showed that the patient was anemic. The patient was diagnosed with ulcerative colitis and was hospitalized on 08-MAY-2008 (the number of days spent in the hospital were unspecified). At the time of this report the patient has not recovered. No product quality complaint was involved. Ulcerative colitis was considered to be disabling. Additional information has been requested. 6/20/08-records received for DOS 5/7-5/12/08-DC DX:Ulcerative colitis. Blood in stools. Admitted for a flare with worsening bloody stools and crampy lower abdominal pain over past 2-3 weeks.Emesis, diminished urine output. Diagnosed with ulcerative colitis 2/08. Began having blood in stool in 7/07, hid her symptoms, determine to be anemic.

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