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This is VAERS ID 618555

Case Details

VAERS ID: 618555 (history)  
Form: Version 1.0  
Age: 13.0  
Gender: Female  
Location: Foreign  
Vaccinated:2014-08-26
Onset:2014-08-26
   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 / UNK 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
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
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.
Allergies:
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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