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This is VAERS ID 335173

Case Details

VAERS ID: 335173 (history)  
Form: Version 1.0  
Age: 12.0  
Gender: Female  
Location: Foreign  
Vaccinated:2008-10-16
Onset:2008-10-28
   Days after vaccination:12
Submitted: 2008-12-11
   Days after onset:44
Entered: 2008-12-12
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Unknown       Purchased by: Unknown
Symptoms: Activities of daily living impaired, Menorrhagia, Thrombosis
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (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
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0812USA02074

Write-up: This case was initially reported to an agency by the health authority and it concerns a 12 year old female patient. The patient had 28 day menstrual cycles with five days bleeding. The patient received GARDASIL. Batch number not reported, on 16-OCT-2008. On 28-OCT-2008, 12 days post vaccination, the patient experienced heavy bleeding with clots which was described as very abnormal and the patient was unable to attend school. At the time of the reporting the patient had not yet recovered. The reporter considered the event to be disabling and medically significant. Other business partner numbers include E200811402. No further information is available.


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