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This is VAERS ID 542161

Case Details

VAERS ID: 542161 (history)  
Form: Version 1.0  
Age:   
Gender: Female  
Location: Foreign  
Vaccinated:2012-05-01
Onset:2013-05-10
   Days after vaccination:374
Submitted: 2014-09-02
   Days after onset:480
Entered: 2014-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / IM

Administered by: Other       Purchased by: Other
Symptoms: Abasia, Insomnia, Limb injury, Pain in extremity
SMQs:, Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Tendinopathies and ligament disorders (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: Prophylaxis
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: WAES1409BRS000484

Write-up: This spontaneous report as received from a physician through a company representative concerning a female patient of unknown age with contraception. In May-2012 the patient was vaccinated with GARDASIL dose 1, .5 ml, intramuscular when the patient used to live abroad. In July 2012 the patient experienced left leg pain. In MAY-2013 the patient experienced can''t walk and can''t sleep. Subsequently, the patient had to come back. On an unknown date the patient experienced twisted foot due to pain. The outcome of can''t walk, twisted foot, can''t sleep and left leg pain (grade 9 to 10) was reported as not recovered/not resolved. The relatedness of patient''s adverse events were not reported. Additional information is not expected. No contact available for follow up.


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