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This is VAERS ID 504992

Case Details

VAERS ID: 504992 (history)  
Form: Version 1.0  
Age: 13.0  
Gender: Female  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2013-10-01
Entered: 2013-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / IM

Administered by: Other       Purchased by: Other
Symptoms: Amenorrhoea, Body temperature fluctuation, Confusional state, Dizziness, Headache, Hyperacusis, Hypoaesthesia, Irritable bowel syndrome, Menorrhagia, Migraine, Nausea, Night sweats, Pain, Photophobia, Rash, Syncope, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Cardiomyopathy (broad), Corneal disorders (broad), Retinal disorders (broad), Hearing impairment (narrow), Vestibular disorders (broad), Fertility disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: WAES1309CAN013914

Write-up: Health Authority Report: this spontaneous report as received from a consumer or other non health professional refers to a 13 year old female patient. On an unknown date the patient was vaccinated with GARDASIL, 1 DF, intramuscular. No other co-suspects were reported. No concomitant medications were reported. On an unknown date the patient experienced amenorrhoea (hospitalization, medically significant and disability), vomiting (hospitalization, medically significant and disability), syncope (hospitalization, medically significant and disability), rash (hospitalization, medically significant and disability), photophobia (hospitalization, medically significant and disability), pain (hospitalization, medically significant and disability), night sweats (hospitalization, medically significant and disability), nausea (hospitalization, medically significant and disability), migraine (hospitalization, medically significant and disability), menorrhagia (hospitalization, medically significant and disability), irritable bowel syndrome, (hospitalization, medically significant and disability), hypoaesthesia (hospitalization, medically significant and disability), hyperacusis (hospitalization, medically significant and disability), headache (hospitalization, medically significant and disability), dizziness (hospitalization, medically significant and disability), confusional state (hospitalization, medically significant and disability) and body temperature fluctuation (hospitalization, medically significant and disability). The outcome of amenorrhoea, vomiting, syncope, rash, photophobia, pain, night sweats, nausea, migraine, menorrhagia, irritable bowel syndrome, hypoaesthesia, hyperacusis, headache, dizziness, confusional state and body temperature fluctuation was reported as not recovered/not resolved. It is unknown if these events are related to GARDASIL. Additional information is not expected.


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