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This is VAERS ID 526689

Case Details

VAERS ID: 526689 (history)  
Form: Version 1.0  
Age:   
Gender: Female  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2014-03-25
Entered: 2014-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. H022294 / UNK UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Orthostatic hypotension
SMQs:, Cardiomyopathy (broad)

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:
Allergies:
Diagnostic Lab Data:
CDC Split Type: WAES1403SWE011186

Write-up: Information has been received from Sanofi Pasteur MSD (SPM) (manufacturer control # E2014-02490) on 21-MAR-2014. Case was received from a health professional via the Health Authorities on 19-Mar-2014 under the reference MPA-2014-001995. Case is medically confirmed. Primary source was a physician. A female patient (gender, weight, height not reported) with no medical history reported received a dose of GARDASIL (batch/lot no. H022294, expiry date 30-JUN-2015) via not reported route and site of administration on an unspecified date. On an unspecified date, the patient developed orthostatic hypotension. At the time of reporting, the patient had not recovered.


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