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This is VAERS ID 517299

Case Details

VAERS ID: 517299 (history)  
Form: Version 1.0  
Age: 13.0  
Gender: Female  
Location: Foreign  
   Days after vaccination:0
Submitted: 2013-12-20
   Days after onset:23
Entered: 2013-12-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Dyspepsia, Headache
SMQs:, Gastrointestinal nonspecific dysfunction (narrow)

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: Constipation; 09/2013, Appendectomy
Diagnostic Lab Data:
CDC Split Type: WAES1312IRL008398

Write-up: This case was received from the health authority on 13-Dec-2013. REF 2013-019028. This case is medically confirmed as it was reported by a physician. A 13 year old female patient (weight: 58 kg), who had a tendency to constipation and had a medical history included appendectomy in Sep-2013, received on 27-Nov-2013 an injection of GARDASIL (batch number J004978), dose in series, route and site of administration not reported. Thirty minutes post vaccination, on 27-Nov-2013, the patient experienced a severe headache and heartburn. Corrective treatment included NUROFEN. The patient was attended on 28-Nov-2013 and was reported as being off school since. At the time of reporting, the patient has not recovered from the adverse events. The health authority considered that case serious due to the patient''s disability and due to be medically significant.

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