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This is VAERS ID 618592

Case Details

VAERS ID: 618592 (history)  
Form: Version 1.0  
Age: 12.0  
Gender: Female  
Location: Foreign  
   Days after vaccination:1346
Submitted: 2015-11-18
   Days after onset:747
Entered: 2015-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Blood glucose, Disturbance in attention, Dizziness, Fatigue, Haemoglobin, Headache, Loss of personal independence in daily activities, Memory impairment, Neurological examination, White blood cell count
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Hypoglycaemia (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 medication
Current Illness: Immunisation
Preexisting Conditions:
Diagnostic Lab Data: The patient has undergone general check up with test for leukocytes, haemoglobin, blood glucose and neurological examination (not further specified).
CDC Split Type: WAES1511DNK009345

Write-up: Information has been received from Sanofi Pasteur MSD (SPM) (manufacturer control # DK-1577272925-E2015-12968) on 17-NOV-2015. Case received from Health Care Professional via Health Authorities on 13-Nov-2015 under the reference number DK-DKMA-ADR 23227614 and DK-DKMA-WBS-0001664. The case is medically confirmed. The primary reporter was physician. A 16-year-old female patient had received three doses of GARDASIL, (lot/batch numbers not reported) via intramuscular route of administration in unspecified site of administration on 18-Aug-2009, 21-Oct-2009 and 24-Feb-2010, respectively. On 1-Nov-2013, she developed dizziness, tiredness, reduced concentration ability/inability to focus, and reduced memory. On an unspecified date, she developed headache, and previously very sports active with horseback riding and training and school, can now almost not manage anything, a lot less riding and sports. The patient does not participate in school education. The case is serious due to seriousness criterion disability. No other vaccines or medications were reported. The patient had undergone general check up with test for leukocytes, haemoglobin, blood glucose and neurological examination (not further specified). No information on medical history was provided. At the time of reporting, the patient had not recovered.

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