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This is VAERS ID 618497

Case Details

VAERS ID: 618497 (history)  
Form: Version 1.0  
Age: 12.0  
Gender: Female  
Location: Foreign  
Submitted: 2015-11-13
Entered: 2015-11-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Blood test normal, Chest pain, Cognitive disorder, Fatigue, Headache, Loss of personal independence in daily activities, Musculoskeletal chest pain, Myalgia, Nuclear magnetic resonance imaging brain normal, Pain in extremity, Palpitations, Sensory disturbance, Visual impairment
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (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: Immunisation
Preexisting Conditions:
Diagnostic Lab Data: Nuclear magnetic resonance imaging brain (MRI) brain: normal; blood tests: normal
CDC Split Type: WAES1511IRL005749

Write-up: Information has been received from SPMSD (manufacturer control# E2015-12661) on 10-NOV-2015. This case was received from the health authority on 06-Nov-2015. Ref IE-HPRA-2015-024996. This case is medically confirmed. A 12-year-old female patient who was not taking any concomitant medication received three doses of GARDASIL (lot number reported as H095341 for dose 1, and lot number reported as J004 for doses 2 and 3), routes and sites not reported, 0.5mls, on 11-Sep-2013, 31-Nov-2013 and 24-Mar-2014. On an unreported date, about six months post vaccination, the patient was developing multiple system problems which have been investigated but no diagnosis has been made to date. The patient''s symptoms included headaches, visual disturbances, chest pains/pains under ribs and sternal area, palpitations at rest and especially when lying down at night, muscle pains, leg pains now and is unable to play sports. The patient also had symptoms of GI reflux but all investigations were normal including MRI brain and blood tests. The patient had recently developed sensory issues and cognitive issues and tires very easily. At the time of reporting the patient''s symptoms were persisting. The reporter considered the events to be serious due to disability.

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