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This is VAERS ID 510201

Case Details

VAERS ID: 510201 (history)  
Form: Version 1.0  
Age: 16.0  
Gender: Male  
Location: Virginia  
Vaccinated:2012-09-18
Onset:2012-11-14
   Days after vaccination:57
Submitted: 2013-10-29
   Days after onset:348
Entered: 2013-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. H014231 / 2 LA / IM

Administered by: Private       Purchased by: Other
Symptoms: Depression, Fatigue, Hypotension, Lethargy, Postural orthostatic tachycardia syndrome
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Penicillin
Allergies:
Diagnostic Lab Data: POTS and NMH
CDC Split Type:

Write-up: Lethargy, extreme fatigue, depression.


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