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This is VAERS ID 323263

Case Details

VAERS ID: 323263 (history)  
Form: Version 1.0  
Age: 15.0  
Gender: Female  
Location: Missouri  
   Days after vaccination:286
Submitted: 2008-08-25
   Days after onset:7
Entered: 2008-08-26
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Abdominal pain upper, Activities of daily living impaired, Arthralgia, Depression, Dizziness, Headache, Insomnia, Nuclear magnetic resonance imaging brain, Oedema peripheral, Pain, Tremor, X-ray limb
SMQs:, Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Depression (excl suicide and self injury) (narrow), Vestibular disorders (broad), Arthritis (broad), Hypoglycaemia (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? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Allergic reaction to antibiotics
Preexisting Conditions:
Diagnostic Lab Data: magnetic resonance - brain; upper extremity X-ray; laboratory test 10/22/08-records received-CBC and chemistry WNL. 12/31/08-records received-Complement C3, C4, CK, metabolic panel , CBC, sed rate, C-reactive protein normal, rheumatoid factor negative, ANA positive. Vitamin D deficiency.
CDC Split Type: WAES0808USA03971

Write-up: Information has been received from a medical assistant concerning a 15 year old female with allergy to CEFZIL and no relevant medical history who on an unspecified date was vaccinated with a dose of GARDASIL (lot number, injection site and route not reported). In November 2007, the patient experienced headaches, stomach ache, dizziness, shakiness, dull and sharp aches all over. The patient also experienced joint pain all over, swelling of the right thumb, depression and insomnia. The patient had been set up with an appointment with a rheumatologist. Laboratory tests (included unspecified lab work, MRI of brain and X-ray of right hand (results unspecified). At time of this report, the patient''s events persisted. According to the reporter, the patient''s events prevented her from school schedule and were considered to be disabling. Additional information has been requested. 10/22/08-records received-presented on 8/8/08 with C/O headache,stomach ache, dizzy and shaking on and off for a while. Generalized pain. Abdominal pain. DX gastritis. Dizziness. 8/18/08 continues with C/O headaches and body aches. DX: arthrlagias, polymyalgias. Swelling of right thumb. Cephalgia. Dep ression. Insomnia. 9/3/08 continues with cephalgia, myalgias and depression.10/1/08-C/O abdominal pain. 12/31/08-records received for DOS 11/10/08-C/O arthralgia/back pain left limb pain. Vitamin D deficiency.

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