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This is VAERS ID 618555

Case Details

VAERS ID: 618555 (history)  
Age: 13.0  
Gender: Female  
Location: Foreign  
   Days after vaccination:0
Submitted: 2015-11-17
   Days after onset:448
Entered: 2015-11-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. J007883 / - UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Pain, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Immunisation
Preexisting Conditions: 11/01/2013 to 11/01/2013, GARDASIL, One dose of GARDASIL batch number J007883 has been administered on 01-Nov-2013.
Diagnostic Lab Data:
CDC Split Type: WAES1511IRL007655

Write-up: Information has been received from Sanofi Pasteur MSD (SPM) (manufacturer control # IE-1577272925-E2015-12871) on 13-NOV-2015. This case was received from the health authority on 11-Nov-2015. Ref IE-HPRA-2015-025099. This case is not medically confirmed as the reporter is a consumer. A 13 year old female patient who was not taking any concomitant medication received injections of GARDASIL, (batch number J007883), route and site not reported, between 01-Nov-2013 and 26-Aug-2014. On 26-Aug-2014, post vaccination, the patient experienced chronic pain and fainting. Corrective treatment included pain killers and anti-inflammatories. At the time of reporting the patient''s symptoms were persisting. The reporter considered the events to be serious due to hospitalisation and disability.

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