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This is VAERS ID 398110

Case Details

VAERS ID: 398110 (history)  
Form: Version 1.0  
Age: 15.0  
Gender: Female  
Location: Unknown  
Vaccinated:2009-07-15
Onset:2009-07-15
   Days after vaccination:0
Submitted: 2010-08-04
   Days after onset:385
Entered: 2010-09-08
   Days after submission:35
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Unknown       Purchased by: Unknown
Symptoms: Activities of daily living impaired, Condition aggravated, Eczema, Fatigue
SMQs:, Dementia (broad), Hypersensitivity (narrow)

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: Eczema
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0907USA02568

Write-up: Information has been received from a pharmacist concerning a 15 year old female with eczema who on 15-JUL-2009 was vaccinated with the first dose of GARDASIL. On 15-JUL-2009 the patient experienced extreme fatigue and an exacerbation of pre existing eczema after her first dose. The patient sought medical attention. Severe fatigue was considered to cause a disability because the patient could not get out of bed. At the report time the patient had not recovered. All telephone attempts to obtain follow-up information have been unsuccessful. Additional information has been requested.


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