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This is VAERS ID 443788

Case Details

VAERS ID: 443788 (history)  
Form: Version 1.0  
Age:   
Gender: Unknown  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2011-11-28
Entered: 2011-11-29
   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: Abdominal pain, Pelvic inflammatory disease
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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: WAES1111USA02627

Write-up: Information has been received from health authority (local reference No. NZL/11/0104) concerning a patient who on an unspecified date was vaccinated with a dose of GARDASIL (lot number, dose and site of administration not reported. No other medications were reported. On an unspecified date, the patient experienced abdominal pain and pelvic inflammation. At the time of the report, the patient''s abdominal pain and pelvic inflammation persisted. The reporter felt that abdominal pain and pelvic inflammation were related to therapy with GARDASIL. Abdominal pain and pelvic inflammation were considered to be disabling by the agency. The original reporting source was not provided. No further information is available.


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