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This is VAERS ID 607376

Case Details

VAERS ID: 607376 (history)  
Form: Version 1.0  
Gender: Female  
Location: Foreign  
Submitted: 2015-08-14
Entered: 2015-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Abdominal pain lower, Arthralgia, Depressed mood, Fatigue, Feeling abnormal, Feeling cold, Memory impairment, Migraine, Pain, Pain in extremity
SMQs:, Retroperitoneal fibrosis (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (narrow), Arthritis (broad), 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: Immunisation
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1508DNK004637

Write-up: Information has been received from Sanofi Pasteur (MSD) (SPM) (manufacturer control # E2015-09140) as part of business agreement on 11-AUG-2015. Case received from non-healthcare professional via Health Authorities on 07-Aug-2015 under the reference number DK-DKMA-ADR 23100854, 15-4764 (patient insurance company). The primary reporter was a lawyer. A adolescent female patient had 3 doses of GARDASIL (batch number not reported) via IM route of administration in not reported site of administration on unspecified date and later on unspecified date she developed tiredness, joint pain, lower abdomen pain, memory impairment, freezing, depressed/feel like her life is destroyed, migraine, pain in whole body, pain in leg. The HA has received the patient''s initial notification to the insurance company. The insurance company has not taken a decision in the case yet. The patient has reported adverse reaction after GARDASIL vaccination. She can not remember the vaccination dates, but reports that the reaction developed after the vaccinations. She reports that she has much pain in lower abdomen, legs and the whole body, she can not remember, she is so tired that she cannot hang together, she has migraine, and is depressed, all her life is destroyed. She is freezing. Joint are hurting. She can not do anything due to pain and tiredness. She cries alot and has constant migraine and strong pain. She is on 100% sick leave due to the reactions. No information on medical history reported. At the time of reporting, the outcome was unknown for freezing, memory impairment and pain in leg and not recovered for all other reactions.

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