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This is VAERS ID 446609

Case Details

VAERS ID: 446609 (history)  
Age: 12.0  
Gender: Female  
Location: Foreign  
Vaccinated:2011-03-29
Onset:2011-03-29
   Days after vaccination:0
Submitted: 2011-12-27
   Days after onset:273
Entered: 2012-01-03
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN

Administered by: Unknown       Purchased by: Unknown
Symptoms: Alopecia, Blindness, Convulsion, Deafness, Dysphemia, Incontinence, Loss of consciousness, Menstrual disorder, Migraine, Nausea, Ovarian cyst ruptured, Pain, Photophobia, Regressive behaviour
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Corneal disorders (broad), Retinal disorders (broad), Hearing impairment (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? 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: WAES1112USA01927

Write-up: Information was obtained on request by the company from the agency via a Public Case Detail form (local reference # AUS/11/1884, OPR 292078) concerning a 12 year old female patient who 29-MAR-2011 was vaccinated with a dose of GARDASIL, (batch # not reported), (route and site not reported), (one dose, one time). On 29-MAR-2011, the patient experienced loss of vision, incontinent, migraines, light sensitivity, black outs, hair loss, burst ovarian cysts, loss of hearing, severe pain, menstrual problems, regression, nausea, seizures and stuttering. "There was no treatment to date as vaccine reaction", the patient was not admitted by any local medical personnel. At the time of the report, the patient''s loss of vision, incontinent, migraines, light sensitivity, black outs, hair loss, burst ovarian cysts, loss of hearing, severe pain, menstrual problems, regression, nausea, seizures and stuttering persisted. This report was considered serious (disability). The agency considered loss of vision, incontinent, migraines, light sensitivity, black outs, hair loss, burst ovarian cysts, loss of hearing, severe pain, menstrual problems, regression, nausea, seizures and stuttering to be possibly related to GARDASIL. The original reporting source was not provided. Additional Information is not expected.


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