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This is VAERS ID 433437

Case Details

VAERS ID: 433437 (history)  
Form: Version 1.0  
Age: 13.0  
Gender: Female  
Location: Foreign  
Vaccinated:2008-10-08
Onset:0000-00-00
Submitted: 2011-09-04
Entered: 2011-09-07
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. NH29070 / 3 UN / UN

Administered by: Private       Purchased by: Private
Symptoms: Abscess, Activities of daily living impaired, Anaemia, Cytomegalovirus infection, Depression, Endoscopy upper gastrointestinal tract, Fatigue, Headache, Immune system disorder, Infection, Infectious mononucleosis, Nausea, Pain, Tonsillectomy, Tonsillitis
SMQs:, Acute pancreatitis (broad), Agranulocytosis (broad), Haematopoietic erythropenia (broad), Dementia (broad), Oropharyngeal infections (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Pending
CDC Split Type:

Write-up: Immune dysfunction, mononucleosis, CMV virus, anemia, chronic fatigue, infections, nausea req''d gastroscopy, headaches, abscesses, tonsillitis led to removal, depression, shooting pains. Absence from school for most of last 2 years.


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