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This is VAERS ID 435386

Case Details

VAERS ID: 435386 (history)  
Form: Version 1.0  
Age: 13.0  
Gender: Female  
Location: Foreign  
Submitted: 2011-09-22
   Days after onset:356
Entered: 2011-09-23
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Unknown       Purchased by: Unknown
Symptoms: Abdominal pain, Activities of daily living impaired, Dizziness, Insomnia, Lethargy
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypoglycaemia (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:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES1109USA01346

Write-up: This report was received from CSL and was assigned manufacturer report number 1000249840 (local reference number AUS-11-1130) concerning an approximately 13 year old female patient who on an unspecified date was vaccinated with a dose of GARDASIL. Since receiving her last dose of GARDASIL from the NIP school programme, in October 2010, the patient had ongoing dizziness, abdominal pains, lethargy and insomnia. The patient had had 20 days this year off school (unable to attend school) as a result of these symptoms. Reporter does not want this adverse event followed up and did not provide consent. Dizziness, abdominal pains, lethargy and insomnia were considered to be disabling since the patient had 20 days off school (unable to attend school) as a result of these symptoms. The original reporting source was not provided. No further information is available.

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