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This is VAERS ID 582612

History of Changes from the VAERS Wayback Machine

First Appeared on 7/14/2015

582612
VAERS Form:
Age:13.0
Gender:Female
Location:Connecticut
Vaccinated:2014-08-27
Onset:2014-09-12
Submitted:2015-06-16
Entered:2015-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. K006447 / 1 AR / IM

Administered by: Private      Purchased by: Private
Symptoms: Autonomic nervous system imbalance, Fatigue, Impaired gastric emptying, Pain in extremity, Autoantibody positive, Postural orthostatic tachycardia syndrome, Complex regional pain syndrome, Weight bearing difficulty

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 17     Extended hospital stay? No
Previous Vaccinations: Fatigue, leg pain~HPV (Gardasil)~1~12.00~Patient
Other Medications: None at the time
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: 4 different autoantibodies have now been detected, including: anti-B1 and B2 adrenergic receptor autoantibodies, anti-M2 muscarinic and Ach ganglionic receptor autoantibodies.
CDC 'Split Type':

Write-up:Within 2 weeks of the vaccine, patient developed significant right leg pain and fatigue. Within 3 weeks, she was unable to bear any weight on her right leg and was diagnosed with CRPS. She developed dysautonomia (POTS, gastroparesis) within 4 or 5 weeks of the vaccine. She has tested positive for anti-B1 and B2 adrenergic receptor autoantibodies plus M2 muscarinic and ganglionic receptor autoantibodies. Her case was written up. Of note, she also developed extreme fatigue and right leg pain after GARDASIL #1, though did not have full blown CRPS symptoms or dysautonomia symptoms until after vaccine #2.


Changed on 8/14/2015

582612 Before After
VAERS Form:
Age:13.0
Gender:Female
Location:Connecticut
Vaccinated:2014-08-27
Onset:2014-09-12
Submitted:2015-06-16
Entered:2015-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. K006447 / 1 AR / IM

Administered by: Private      Purchased by: Private
Symptoms: Autonomic nervous system imbalance, Fatigue, Impaired gastric emptying, Pain in extremity, Autoantibody positive, Postural orthostatic tachycardia syndrome, Complex regional pain syndrome, Weight bearing difficulty

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 17 9     Extended hospital stay? No
Previous Vaccinations: Fatigue, leg pain~HPV (Gardasil)~1~12.00~Patient
Other Medications: None at the time
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: 4 different autoantibodies have now been detected, including: anti-B1 and B2 adrenergic receptor autoantibodies, anti-M2 muscarinic and Ach ganglionic receptor autoantibodies.
CDC 'Split Type':

Write-up:Within 2 weeks of the vaccine, patient developed significant right leg pain and fatigue. Within 3 weeks, she was unable to bear any weight on her right leg and was diagnosed with CRPS. She developed dysautonomia (POTS, gastroparesis) within 4 or 5 weeks of the vaccine. She has tested positive for anti-B1 and B2 adrenergic receptor autoantibodies plus M2 muscarinic and ganglionic receptor autoantibodies. Her case was written up. Of note, she also developed extreme fatigue and right leg pain after GARDASIL #1, though did not have full blown CRPS symptoms or dysautonomia symptoms until after vaccine #2.


Changed on 9/14/2017

582612 Before After
VAERS Form:(blank) 1
Age:13.0
Gender:Female
Location:Connecticut
Vaccinated:2014-08-27
Onset:2014-09-12
Submitted:2015-06-16
Entered:2015-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. K006447 / 1 2 AR / IM

Administered by: Private      Purchased by: Private
Symptoms: Autonomic nervous system imbalance, Fatigue, Impaired gastric emptying, Pain in extremity, Autoantibody positive, Postural orthostatic tachycardia syndrome, Complex regional pain syndrome, Weight bearing difficulty

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 9     Extended hospital stay? No
Previous Vaccinations: Fatigue, leg pain~HPV (Gardasil)~1~12.00~Patient
Other Medications: None at the time
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: 4 different autoantibodies have now been detected, including: anti-B1 and B2 adrenergic receptor autoantibodies, anti-M2 muscarinic and Ach ganglionic receptor autoantibodies.
CDC 'Split Type':

Write-up:Within 2 weeks of the vaccine, patient developed significant right leg pain and fatigue. Within 3 weeks, she was unable to bear any weight on her right leg and was diagnosed with CRPS. She developed dysautonomia (POTS, gastroparesis) within 4 or 5 weeks of the vaccine. She has tested positive for anti-B1 and B2 adrenergic receptor autoantibodies plus M2 muscarinic and ganglionic receptor autoantibodies. Her case was written up. Of note, she also developed extreme fatigue and right leg pain after GARDASIL #1, though did not have full blown CRPS symptoms or dysautonomia symptoms until after vaccine #2.


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