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This is VAERS ID 531010

History of Changes from the VAERS Wayback Machine

First Appeared on 9/14/2014

VAERS ID: 531010
Age:14.0
Gender:Female
Location:Foreign
Vaccinated:2013-06-20
Onset:2013-06-21
Submitted:2014-05-15
Entered:2014-05-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. J000396 / 0 AR / IM

Administered by: Other      Purchased by: Other
Symptoms: Depression, Lymphoedema, Oedema peripheral, Venogram abnormal, Ultrasound scan abnormal, Manual lymphatic drainage

Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, days: 16     Extended hospital stay? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Immunisation
Preexisting Conditions:
Diagnostic Lab Data: 17-OCT-2013: Sonogram: lymphoedema grade II; 18-OCT-2013, Phlebography: lymphoedema
CDC 'Split Type': WAES1405DEU006905

Write-up:Information has been received from Sanofi Pasteur MSD (SPM) (manufacturer control # DE-1577272925-E2014-04013) on 13-MAY-2014. Case was received from a physician on 08-May-2014. Case is medically confirmed. A 14-year-old female patient (weight: 45.2 kg; height: 152 cm) received a first dose of GARDASIL (lot-no. J000396, Exp. Date: 31-JUL-2015 - this batch was not released by HA for SPMSD) IM into the deltoid muscle on 20-Jun-2013. One day later, on 21-Jun-2013, she developed lymphoedema of the right upper ankle joint. During the further course the oedema was spreading to the right lower leg. On 20-Aug-2013 the patient received the second dose of GARDASIL (lot-no. J001201, Exp. Date: 04-JUL-2015) IM into the deltoid muscle. The patient was hospitalised from 12-to 27-Sep-2013, the report was not provided. On 17-Oct-2013 duplex sonography showed lymphoedema grade II. On 18-Oct-2013 diagnosis of lymphoedema of the upper ankle joint was confirmed by phlebography. Since 17-Feb-2014 she additionally developed lymphoedema of the right wrist. On 24-Feb-2014 she received the third dose of GARDASIL (lot-no. J004473, Exp. Date: 12-OCT-2015) IM into the deltoid muscle. The patient was treated with support stockings and lymph drainage twice a week. Since Feb-2014 the patient additionally developed depressive episodes due to lymphoedema. She was treated with psychotherapy. At the time of reporting the patient had not recovered and the reporter assessed a "persisting damage". According to the reporter, the reaction was possibly related to vaccination.


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