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This is VAERS ID 522457

History of Changes from the VAERS Wayback Machine

First Appeared on 3/14/2014

VAERS ID: 522457
Age:11.0
Gender:Female
Location:Unknown
Vaccinated:2013-09-04
Onset:2013-10-27
Submitted:2014-02-12
Entered:2014-02-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. H020002 / 0 RA / IM

Administered by: Other      Purchased by: Other
Symptoms: Disability, Fatigue, Headache, Infectious mononucleosis

Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1402USA004484

Write-up:This spontaneous report as received from a pharmacist via company representative refers to a 12 year old female patient (also reported as the pharmacist''s daughter). The patient did not have any pertinent medical history. On an unknown date in October 2013, the patient was vaccinated with a first dose of GARDASIL (route, dose, lot number and expiry date were not reported). On an unknown date in 2013, a couple of weeks later, after administration of GARDASIL the patient developed mononucleosis (disability) with a chronic headache (disability) and fatigue (disability). The pharmacist did not administer GARDASIL again and therapy with GARDASIL was discontinued. The outcome of the events mononucleosis, chronic headache and fatigue were unknown. The events mononucleosis, chronic headache and fatigue led to disability. Additional information has been requested.


Changed on 6/14/2014

VAERS ID: 522457 Before After
Age:11.0
Gender:Female
Location:Unknown
Vaccinated:2013-09-04
Onset:2013-10-27
Submitted:2014-02-12
Entered:2014-02-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. H020002 / 0 RA / IM

Administered by: Other      Purchased by: Other
Symptoms: Disability, Fatigue, Headache, Infectious mononucleosis

Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1402USA004484

Write-up:This spontaneous report as received from a pharmacist via company representative refers to a 12 year old female patient (also reported as the pharmacist''s daughter). The patient did not have any pertinent medical history. On an unknown date in October 2013, the patient was vaccinated with a first dose of GARDASIL (route, dose, lot number and expiry date were not reported). On an unknown date in 2013, a couple of weeks later, after administration of GARDASIL the patient developed mononucleosis (disability) with a chronic headache (disability) and fatigue (disability). The pharmacist did not administer GARDASIL again and therapy with GARDASIL was discontinued. The outcome of the events mononucleosis, chronic headache and fatigue were unknown. The events mononucleosis, chronic headache and fatigue led to disability. Additional information has been requested.


Changed on 3/14/2015

VAERS ID: 522457 Before After
Age:11.0
Gender:Female
Location:Unknown
Vaccinated:2013-09-04
Onset:2013-10-27
Submitted:2014-02-12
Entered:2014-02-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. H020002 / 0 RA / IM

Administered by: Other      Purchased by: Other
Symptoms: Disability, Fatigue, Headache, Infectious mononucleosis

Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1402USA004484

Write-up:This spontaneous report as received from a pharmacist via company representative refers to a 12 year old female patient (also reported as the pharmacist''s daughter). The patient did not have any pertinent medical history. On an unknown date in October 2013, the patient was vaccinated with a first dose of GARDASIL (route, dose, lot number and expiry date were not reported). On an unknown date in 2013, a couple of weeks later, after administration of GARDASIL the patient developed mononucleosis (disability) with a chronic headache (disability) and fatigue (disability). The pharmacist did not administer GARDASIL again and therapy with GARDASIL was discontinued. The outcome of the events mononucleosis, chronic headache and fatigue were unknown. The events mononucleosis, chronic headache and fatigue led to disability. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=522457&WAYBACKHISTORY=ON


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