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This is VAERS ID 506668

Case Details

VAERS ID: 506668 (history)  
Form: Version 1.0  
Age: 14.0  
Gender: Female  
Location: Foreign  
Vaccinated:0000-00-00
Onset:2009-10-01
Submitted: 2013-10-09
   Days after onset:1469
Entered: 2013-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Activities of daily living impaired, Chronic fatigue syndrome
SMQs:, Dementia (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: No other medications
Current Illness: Immunisation
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: WAES1310GBR002905

Write-up: This case was received from the health authority on 27-Sep-2013. GB-MHRA-ADR 22251540. This case is not medically confirmed as it was reported by a consumer. A 14-year-old female patient (weight 53 kg), with no reported medical history, received on an unreported date an injection of human papilloma virus vaccine (mfr unknown; batch n., route, dose, dose in series and site of administration not reported) and in Oct-2009 she developed chronic fatigue syndrome. On an unreported date she also experienced activities of daily living impaired. She was unable to attend school or carry on normal life. At the time of reporting the patient had not recovered. The agency considered this case to be serious due to disability/incapacity and as an other medically important condition.


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