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This is VAERS ID 440061

Case Details

VAERS ID: 440061 (history)  
Form: Version 1.0  
Sex: Female  
Location: Unknown  
Submitted: 2011-10-25
Entered: 2011-10-26
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Childhood disintegrative disorder, Educational problem, Learning disorder, Reading disorder
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: WAES1110USA02911

Write-up: A consumer obtained the information from a website concerning a female student patient who was an honor roll student in the seventh grade, failing in the eighth grade and starting high school in a special education class in diapers who on an unspecified date was vaccinated with a dose of GARDASIL (lot number, dose and route not provided). On an unspecified date, the patient was reading at a fifth grade level with maybe the comprehension of fourth grader. She was kicked out of school that year in just the third week. At the time of this report, the patient''s outcome was unknown. Upon internal review "she was reading at a fifth grade level with maybe the comprehension of fourth grader and she was kicked out of school" were considered to be disabling. No further information is available.

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