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This is VAERS ID 380469

Case Details

VAERS ID: 380469 (history)  
Form: Version 1.0  
Age: 16.0  
Gender: Female  
Location: Iowa  
Vaccinated:2009-10-13
Onset:2009-10-19
   Days after vaccination:6
Submitted: 2010-02-15
   Days after onset:119
Entered: 2010-02-16
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0311Y / 2 LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Decreased appetite, Disturbance in attention, Fatigue, Headache, Laboratory test normal, Lethargy, Nausea, No reaction on previous exposure to drug, Ultrasound abdomen normal, Vomiting
SMQs:, Acute pancreatitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (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:
Allergies:
Diagnostic Lab Data: computed axial, NL normal limits; diagnostic laboratory, within normal limits. Brain MRI normal.
CDC Split Type: WAES0912USA02484

Write-up: Information has been received from a physician concerning a 16 year old female patient who in August 2009, was vaccinated with the second dose of GARDASIL. According to the physician, the patient developed headaches and fatigue after the second dose of GARDASIL. At the time of the report the patient had not recovered. The patient sought medical attention by an office visit. Follow up information has been received from the physician who indicated that the patient was a female student with no known drug allergies/reactions and no pertinent medical history who on 11-AUG-2009 was vaccinated with her first dose of GARDASIL (LOT # 659054/0311Y) intramuscularly into her left arm at 14:10 pm and on 13-OCT-2009 was vaccinated with her second dose of GARDASIL (LOT # 659054/0311Y) intramuscularly into her left deltoid at 13:50 pm. No illnesses were reported at the time of vaccination. It was reported that on approximately 19-OCT-2009 the patient began experiencing headaches, daily nausea, loss of appetite, vomiting, lethargy and inability to concentrate. At the time of the report the patient had not recovered. Diagnostic laboratory tests were performed included a CT scan and the US of abdomen reportedly as normal limits, other diagnostic tests were within normal limits and other labs and hospital visits per other physician. The reporting physician considered headaches, daily nausea, loss of appetite, vomiting, lethargy and inability to concentrate to be disabling/incapacitating events since the patient missed many days at school (additional information was not legible). Additional information is not expected.


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