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This is VAERS ID 517633

Case Details

VAERS ID: 517633 (history)  
Age: 15.0  
Gender: Female  
Location: Unknown  
Vaccinated:2013-07-26
Onset:2013-08-01
   Days after vaccination:6
Submitted: 2013-12-24
   Days after onset:145
Entered: 2013-12-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. H020692 / - UN / IM

Administered by: Other       Purchased by: Other
Symptoms: Activities of daily living impaired, Balance disorder, Dizziness, Dysstasia, Gait disturbance, Headache, Nausea, Palpitations
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: YAZ
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1312USA009931

Write-up: This spontaneous report as received from a physician via a company representative refers to a 15 year old female patient. Patient was not pregnant. The patient had no pertinent medical history. Drug reactions/allergies were none. On 26-JUL-2013 the patient was vaccinated with GARDASIL, intramuscular (dose, dosage, lot not reported). Concomitant therapies included YAZ. On an unknown date of August-2013 the patient experienced headache, nausea, heart palpitations, dizziness and trouble with balance after receiving the vaccine. The patient has had difficulty standing (disability) and trouble walking (disability) and because of this has been out of school for 2 months. The patient saw the physician and sought medical attention. It was also reported that the patient will not continue with the series. The outcomes of the reported events were unknown at the time of the report. The events difficulty standing and trouble walking were considered to be serious due to disability. Additional information has been requested.


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