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This is VAERS ID 456825

Case Details

VAERS ID: 456825 (history)  
Age: 13.0  
Gender: Female  
Location: New Jersey  
Vaccinated:2012-01-30
Onset:2012-03-05
   Days after vaccination:35
Submitted: 2012-06-05
   Days after onset:91
Entered: 2012-06-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Private       Purchased by: Private
Symptoms: Anaemia, Arthralgia, Pulmonary haemorrhage, Purpura, Respiratory failure, Vasculitis
SMQs:, Anaphylactic reaction (broad), Haematopoietic erythropenia (broad), Haemorrhage terms (excl laboratory terms) (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Vasculitis (narrow), Hypersensitivity (broad), Arthritis (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 20 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Joint pain that progressed over the next couple of weeks to anemia, purpuric rash, vasculitis, pulmonary hemorrhage, respiratory failure.


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