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This is VAERS ID 414723

Case Details

VAERS ID: 414723 (history)  
Form: Version 1.0  
Gender: Female  
Location: Unknown  
Submitted: 2011-01-13
Entered: 2011-01-14
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Activities of daily living impaired, Autonomic nervous system imbalance, Fatigue, Gastric disorder, Orthostatic hypotension, Syncope, Tachycardia
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (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: WAES1011USA00219

Write-up: Information has been received from a physical therapist concerning three female patients who on an unspecified date were vaccinated with a dose of GARDASIL (lot# not reported). It was reported that on an unspecified date, the patients were suffering from dysautonomia. At the time of the report, the patients'' outcomes were unknown. It was unknown if the patient sought medical attention. Follow up information has been received from the physical therapist concerning a current 13 year old female patient who developed orthostatic hypotension, tachycardia, "tummy trouble", fainting, and chronic fatigue after she received GARDASIL (lot and date unknown). She did not go to school for long periods of time because of these symptoms. The physical therapist stated that this condition has been "life altering". At the time of this report, the patient''s outcome was unknown. Orthostatic hypotension, tachycardia, "tummy trouble", fainting and chronic fatigue were considered to be disabling. This is one of several reports received from the same source. No further information is available.

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