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This is VAERS ID 387595

Case Details

VAERS ID: 387595 (history)  
Form: Version 1.0  
Age: 14.0  
Gender: Female  
Location: Foreign  
Submitted: 2010-05-14
Entered: 2010-05-17
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Unknown       Purchased by: Unknown
Symptoms: Abdominal pain upper, Autonomic nervous system imbalance, Chest pain, Dizziness, Dyspnoea, Fatigue, Nausea, Oropharyngeal pain, Pharyngitis, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal infections (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), 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: Unknown
CDC Split Type: WAES1005USA01078

Write-up: Information was obtained on a request by the Company from the agency via a Public Case Detail concerning a 14 year old female patient who on 04-APR-2008 was vaccinated with a dose of GARDASIL (lot number not reported). Subsequently the patient experienced fatigue, nausea, dizziness, antonomic instability, fainting, breathlessness, pain in stomach, chest, sore throat and recurrent throat infections. The patient was graded return to activity. At the time of the report, the patient had not yet recovered. The reporter felt that fatigue, dizziness, pharyngitis and syncope were possibly related to GARDASIL. Fatigue, dizziness, pharyngitis and syncope were considered to be disabling. The original reporting source was not provided. Additional information is not expected.

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