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This is VAERS ID 443797

Case Details

VAERS ID: 443797 (history)  
Form: Version 1.0  
Gender: Unknown  
Location: Foreign  
Submitted: 2011-11-28
Entered: 2011-11-29
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Unknown       Purchased by: Unknown
Symptoms: Arthralgia, Headache, Lymphadenopathy, Muscular weakness, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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: WAES1111USA02625

Write-up: Information has been received from health authority (local reference No. NZL/11/0102) concerning a patient who on an unspecified date was vaccinated with a dose of GARDASIL (lot number, dose and site of administration not reported). On unspecified date, the patient experienced paraesthesia, lymphadenopathy, arthralgia, headache and muscle weakness. At the time of the report, the patient''s paraesthesia, lymphadenopathy, arthralgia, headache and muscle weakness persisted. Paraesthesia, lymphadenopathy, arthralgia, headache and muscle weakness were considered to be disabling by the agency. The reporter felt that paraesthesia, lymphadenopathy, arthralgia, headache and muscle weakness were related to therapy with GARDASIL. The original reporting source was not provided. No further information is available.

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