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This is VAERS ID 612684

Case Details

VAERS ID: 612684 (history)  
Form: Version 1.0  
Age: 12.0  
Gender: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2015-12-02
Entered: 2015-12-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / SYR

Administered by: Other       Purchased by: Other
Symptoms: Activities of daily living impaired, Blindness transient, Chronic fatigue syndrome, Emotional disorder, Fatigue, Feeling abnormal, Headache, Injection site haemorrhage, Lymph node pain, Mobility decreased, Pain, Visual field defect, Weight increased
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Anticholinergic syndrome (broad), Dementia (broad), Embolic and thrombotic events, arterial (narrow), Parkinson-like events (broad), Noninfectious encephalitis (broad), Glaucoma (broad), Optic nerve disorders (broad), Retinal disorders (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Cervix carcinoma
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: WAES1512USA000013

Write-up: This spontaneous report was received from the consumer''s mother on a newspaper article and refers to a 12 year old female patient. The patient''s medical history and concurrent condition were not reported. The patient on an unknown date in 2010 was vaccinated with quadrivalent HPV vaccine (manufacturer unknown) (dosing information not provided). Concomitant medication were not reported. After the first shot on an unknown date in 2010, it was reported that the patient had sore glands, headaches and tiredness, all normal symptoms which had subsided after a few days. Following the second shot on an unknown date, the patient had profuse bleeding from the injection site and then developed severe headaches. On an unknown date within eleven months the patient was barely able to get out of bed. She was surviving on rice cakes and water yet had piled on 3 stones in two months. Every inch of her body had ached. Numerous trips to the General Physician (GP) and tests conducted at the hospital (unspecified) failed to get a diagnosis other than teenage hormones or emotional problems. On an unknown date in 2013 the patient was diagnosed with chronic fatigue syndrome by a pediatrician (unspecified). It was reported that the patient didn''t feel right after the vaccine. The patient had coped with initial symptoms but now on an unknown date had chronic pains, her left leg has started to turn in. It was reported that the patient on an unknown date 18 months ago had lost her eyesight. It came back but the peripheral sight in her left eye never came back. The patient was under a neurologist (unspecified) for ice pick headaches. Action taken with quadrivalent HPV vaccine (manufacturer unknown) was not applicable. The outcome of activities of daily living impaired, visual field defect, chronic fatigue syndrome, pain (chronic pain), injection site hemorrhage and headache (severe headache and ice pick headache) was unknown. The outcome of lymphadenopathy, headache and fatigue was reported as recovered on an unknown date. The patient was recovering from blindness. The reporter did not provide the causality assessment between the events and quadrivalent HPV vaccine (manufacturer unknown). The event "barely able to get out of bed" was considered serious due to disability and upon internal review the event visual field defect, blindness were considered serious as medically significant. This case is linked to the case 1512USA001052 and 1512USA001053. Additional information has been requested.


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