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This is VAERS ID 399490

Case Details

VAERS ID: 399490 (history)  
Form: Version 1.0  
Age: 13.0  
Gender: Female  
Location: Unknown  
Submitted: 2010-08-04
Entered: 2010-09-08
   Days after submission:35
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Activities of daily living impaired, Malaise
SMQs:, Dementia (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: WAES0911USA02370

Write-up: Information has been received from a Nurse Practitioner (N.P) who was being questioned by people in her community. There was a female patient "between 13 or 14 year old" who on an unspecified date was vaccinated with a dose of GARDASIL. It was reported that the patient became very ill and she was not attending school. The Nurse Practitioner stated that none of her patients experienced any adverse events and this was not her patient. The nurse practitioner questioned if there was any GARDASIL lot number that was bad or recalled. The outcome of the patient was not reported. Upon internal review became very ill was considered to be disabling due to the patient was not attending school. This is a hearsay report in the absence of an identifiable patient. Attempts are being made to verify the existence of a patient.

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