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This is VAERS ID 563595

Case Details

VAERS ID: 563595 (history)  
Form: Version 1.0  
Gender: Female  
Location: Unknown  
Submitted: 2015-02-04
Entered: 2015-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Activities of daily living impaired, Postural orthostatic tachycardia syndrome
SMQs:, Dementia (broad), Dehydration (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: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1502USA000852

Write-up: This spontaneous report as received from a consumer refers to a currently 17-year-old female, who was the reporter''s cousin in law''s daughter. The patient''s medical history and concurrent conditions were not reported. On an unknown dates, the patient was vaccinated with 3 doses of GARDASIL (doses, routes of administration, anatomical locations, lot# and exp. dates were not reported). Concomitant therapies were not reported. On an unknown date, reported as "several years ago", the patient was diagnosed with Postural Orthostatic Tachycardia Syndrome (POTS). History and details of the diagnosis were not specified. It was reported that the patient was athletic and was playing sports at the time her symptoms started. Since diagnosis the patient was unable to play sports and her activities were limited. The patient was visiting acupuncturist to help her with the symptoms. The outcome of the events was unknown. The relatedness between vaccination with GARDASIL and the events was unknown. Upon internal review, the event of being unable to play sports and limited activities was considered to be disabling. Additional information has been requested.

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