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This is VAERS ID 513091

History of Changes from the VAERS Wayback Machine

First Appeared on 3/14/2014

VAERS ID: 513091
Age:13.0
Gender:Female
Location:Foreign
Vaccinated:2008-11-04
Onset:2009-01-01
Submitted:2013-11-14
Entered:2013-11-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Arthralgia, Chest pain, Dyspnoea, Headache, Myalgia, Nuclear magnetic resonance imaging brain, Neurological examination, Computerised tomogram head, Blood test

Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Immunisation
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1311DNK005011

Write-up:Case of adverse event received from health care professional via Health Authority on 05-Nov-2013 under the reference number DK-DKMA-ADR 22271499 and DK-DKMA-EFO7164. The primary reporter was a physician. Case is medically confirmed. A 13 year old female patient (weight: 58 kg; height: 166 cm), with no medical history reported, had received the primary dose of GARDASIL (batch number not reported) via intramuscular route of administration in not reported site of administration on 04-Nov-2008 and later on a non-specified date in Jan-2009 she developed air hunger, headache, chest pain, muscle pain and joint pain. Blood tests, pediatric examination for asthma, neurological examination, CT-scan and MRI-scan of the cerebrum was performed on a non-specified date (lab results not reported). The patient had no other medications. The patient received the second and third dose of GARDASIL (batch number not reported) via intramuscular route of administration in not reported site of administration on 24-Mar-2009 and 04-Aug-2009 respectively. At the time of reporting, the outcome was recovering from all reported adverse events.


Changed on 6/14/2014

VAERS ID: 513091 Before After
Age:13.0
Gender:Female
Location:Foreign
Vaccinated:2008-11-04
Onset:2009-01-01
Submitted:2013-11-14
Entered:2013-11-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Arthralgia, Chest pain, Dyspnoea, Headache, Myalgia, Nuclear magnetic resonance imaging brain, Neurological examination, Computerised tomogram head, Blood test

Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Immunisation
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1311DNK005011

Write-up:Case of adverse event received from health care professional via Health Authority on 05-Nov-2013 under the reference number DK-DKMA-ADR 22271499 and DK-DKMA-EFO7164. The primary reporter was a physician. Case is medically confirmed. A 13 year old female patient (weight: 58 kg; height: 166 cm), with no medical history reported, had received the primary dose of GARDASIL (batch number not reported) via intramuscular route of administration in not reported site of administration on 04-Nov-2008 and later on a non-specified date in Jan-2009 she developed air hunger, headache, chest pain, muscle pain and joint pain. Blood tests, pediatric examination for asthma, neurological examination, CT-scan and MRI-scan of the cerebrum was performed on a non-specified date (lab results not reported). The patient had no other medications. The patient received the second and third dose of GARDASIL (batch number not reported) via intramuscular route of administration in not reported site of administration on 24-Mar-2009 and 04-Aug-2009 respectively. At the time of reporting, the outcome was recovering from all reported adverse events.


Changed on 3/14/2015

VAERS ID: 513091 Before After
Age:13.0
Gender:Female
Location:Foreign
Vaccinated:2008-11-04
Onset:2009-01-01
Submitted:2013-11-14
Entered:2013-11-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Arthralgia, Chest pain, Dyspnoea, Headache, Myalgia, Nuclear magnetic resonance imaging brain, Neurological examination, Computerised tomogram head, Blood test

Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Immunisation
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1311DNK005011

Write-up:Case of adverse event received from health care professional via Health Authority on 05-Nov-2013 under the reference number DK-DKMA-ADR 22271499 and DK-DKMA-EFO7164. The primary reporter was a physician. Case is medically confirmed. A 13 year old female patient (weight: 58 kg; height: 166 cm), with no medical history reported, had received the primary dose of GARDASIL (batch number not reported) via intramuscular route of administration in not reported site of administration on 04-Nov-2008 and later on a non-specified date in Jan-2009 she developed air hunger, headache, chest pain, muscle pain and joint pain. Blood tests, pediatric examination for asthma, neurological examination, CT-scan and MRI-scan of the cerebrum was performed on a non-specified date (lab results not reported). The patient had no other medications. The patient received the second and third dose of GARDASIL (batch number not reported) via intramuscular route of administration in not reported site of administration on 24-Mar-2009 and 04-Aug-2009 respectively. At the time of reporting, the outcome was recovering from all reported adverse events.


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