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This is VAERS ID 410940

Case Details

VAERS ID: 410940 (history)  
Form: Version 1.0  
Age: 16.0  
Gender: Female  
Location: Unknown  
   Days after vaccination:0
Submitted: 2010-12-01
   Days after onset:1218
Entered: 2010-12-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Acne, Activities of daily living impaired, Alopecia, Arthralgia, Back pain, Chest pain, Decreased activity, Depression, Disturbance in attention, Dizziness, Dry mouth, Dysmenorrhoea, Dyspnoea, Fatigue, Hot flush, Increased tendency to bruise, Insomnia, Menorrhagia, Menstruation irregular, Migraine, Muscle spasms, Nausea, Oedema peripheral, Pain, Pain in extremity, Painful respiration, Palpitations, Paraesthesia, Stomatitis, Swelling, Swelling face, Tenderness, Tunnel vision, Vision blurred, Visual impairment, Weight increased
SMQs:, Cardiac failure (broad), Severe cutaneous adverse reactions (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Dystonia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (narrow), Depression (excl suicide and self injury) (narrow), Vestibular disorders (broad), Fertility disorders (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

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:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES1011USA03649

Write-up: Information has been received from a physician who received the information from a consumer that provided him a link to a forum. The patient''s mother posted a comment on a website concerning her 16 year old daughter who in August 2007 was vaccinated with a first dose of GARDASIL (lot # not reported). The patient developed an onset of symptoms approximately 3 weeks after receiving the first dose of the vaccine. The main symptoms were pain in her lower extremities; the pain started in her legs and spread to her hips, low back and mid back. Pain when taking a breath, heart palpitations. The symptoms did not improve, they continued to get worse. The patient experienced swelling only when she was lying down. The swelling occurred in her hands, feet, and face. Pain and tingling, prickling sensation in her hands and feet. Migraine headaches, dizziness, and difficulty concentrating. The patient was unable to participate in the activities she enjoyed. The patient was placed on homebound due to the amount of school she had missed. The patient saw numerous doctors but did not get a relief or answers for her symptoms. By the time of the consumer''s report, the patient had been suffering the effects from GARDASIL for 2 1/2 years. She managed to graduate from high school but it was not easy. Her grades dropped and she did not get the scholarships she had strived hard for. She had to give up activities she so loved. Every day was a struggle for her. She was attending college but had to opt to go to a college close to home rather that the university she had planned to attend. The patient''s current symptoms were: Increased acne, severe hot flashes, weight gain, hair loss, swelling, severe dry mouth, depression, fatigue, severe unbearable pain, nausea, heavy painful, irregular menstrual cycle, chest pain, heart palpitations, trouble breathing, tenderness to touch, easily bruises, muscle spasms, vision changes (blurred, tunnel vision), mouth sores (on tongue and cheeks), hip and knee pain both sides, trouble sleeping, trouble concentrating and decreased tolerance of physical activity. Upon internal review, "unable to participate in the activities she enjoyed; placed on homebound due to school she missed" was considered to be disabling. No further information is available.

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