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This is VAERS ID 443463

Case Details

VAERS ID: 443463 (history)  
Form: Version 1.0  
Age:   
Gender: Unknown  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2011-11-22
Entered: 2011-11-23
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Unknown       Purchased by: Unknown
Symptoms: Anxiety, Chills, Fatigue, Insomnia
SMQs:, 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES1111USA02622

Write-up: Information has been received from an agency via CSL (local reference# NZL/11/0100) concerning a patient who on an unknown date was vaccinated with a dose of GARDASIL (lot# unspecified). On an unknown date, the patient experienced rigors, insomnia, anxiety and fatigue. At the time of report, the patient had not recovered from the events. Rigors, insomnia, anxiety and fatigue were considered as persisting disability by the agency. The original reporting source was not provided. No further information is available.


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