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This is VAERS ID 619025

History of Changes from the VAERS Wayback Machine

First Appeared on 6/14/2017

619025
VAERS Form:
Age:13.0
Gender:Female
Location:Foreign
Vaccinated:2008-10-30
Onset:2008-10-30
Submitted:2015-11-23
Entered:2015-11-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Arthralgia, Constipation, Cyanosis, Dizziness, Dyspepsia, Ear pain, Fatigue, Gastrooesophageal reflux disease, Headache, Hypersomnia, Increased tendency to bruise, Muscular weakness, Neuralgia, Oral mucosal blistering, Pain in extremity, Peripheral coldness, Pollakiuria, Sensory disturbance, Skin discolouration, Vision blurred, Wheelchair user, Grip strength decreased, Weight bearing difficulty, Loss of personal independence in daily activities

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Immunisation
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES1511DNK010750

Write-up:Information has been received from Sanofi Pasteur MSD (SPMSD) Case Report N. DK-1577272925-E2015-13059) on 18-NOV-2015. Case received from Patient Insurance Company (PIC) via Health Authorities on 16-Nov-2015 under the reference number DK-DKMA-ADR 23233468. The case is not medically confirmed. The primary reporter was a lawyer. A 13-year-old female patient had received three doses of GARDASIL (batch numbers not reported) via unspecified route of administration in unspecified site of administration on 30-Oct-2008, not reported date, and on 06-May-2009. On 30-Oct-2008, she developed headache, tiredness rapid exhaustion becomes markedly tired at small exertions, dizziness, feels that the eyes are blurry and vision becomes unclear, sleeps a lot, develops often blister in the mouth, acid reflux heartburn, tendency to constipation, develops pain in the ears, pain in both lower arms and hands, weakness in both lower arms and hands cannot support her own bodyweight at hips knee and ankles drops things from the hands, hands arms and fingers buzz, blue discoloration of nails, cold hands and feet, bruises easily, feels need to urinate often, severe neurogenic pain in lower legs and feet, and blue mottling patches/discoloration in the skin. On unspecified day in Nov-2008, she developed joint pain. On not reported date, she developed sits in wheelchair cannot manage much so her day is lying in bed, sofa and on toilet and go to physiotherapy. The HA received the case from the Patient Insurance Company (PIC) in the form of the patient''s claim. PIC has not yet made a decision in the matter. The patient has been on sick leave since 22-May-2014. Through the municipality, she has received a rehabilitation progression that lasts until Sep-2020. The case is serious due to seriousness criteria hospitalization and disability. No other medications. No information on medical history provided. At the time of reporting, the outcome was unknown for the reaction joint pain. The patient had not recovered from the other reactions.


Changed on 9/14/2017

619025 Before After
VAERS Form:(blank) 1
Age:13.0
Gender:Female
Location:Foreign
Vaccinated:2008-10-30
Onset:2008-10-30
Submitted:2015-11-23
Entered:2015-11-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Arthralgia, Constipation, Cyanosis, Dizziness, Dyspepsia, Ear pain, Fatigue, Gastrooesophageal reflux disease, Headache, Hypersomnia, Increased tendency to bruise, Muscular weakness, Neuralgia, Oral mucosal blistering, Pain in extremity, Peripheral coldness, Pollakiuria, Sensory disturbance, Skin discolouration, Vision blurred, Wheelchair user, Grip strength decreased, Weight bearing difficulty, Loss of personal independence in daily activities

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Immunisation
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES1511DNK010750

Write-up:Information has been received from Sanofi Pasteur MSD (SPMSD) Case Report N. DK-1577272925-E2015-13059) on 18-NOV-2015. Case received from Patient Insurance Company (PIC) via Health Authorities on 16-Nov-2015 under the reference number DK-DKMA-ADR 23233468. The case is not medically confirmed. The primary reporter was a lawyer. A 13-year-old female patient had received three doses of GARDASIL (batch numbers not reported) via unspecified route of administration in unspecified site of administration on 30-Oct-2008, not reported date, and on 06-May-2009. On 30-Oct-2008, she developed headache, tiredness rapid exhaustion becomes markedly tired at small exertions, dizziness, feels that the eyes are blurry and vision becomes unclear, sleeps a lot, develops often blister in the mouth, acid reflux heartburn, tendency to constipation, develops pain in the ears, pain in both lower arms and hands, weakness in both lower arms and hands cannot support her own bodyweight at hips knee and ankles drops things from the hands, hands arms and fingers buzz, blue discoloration of nails, cold hands and feet, bruises easily, feels need to urinate often, severe neurogenic pain in lower legs and feet, and blue mottling patches/discoloration in the skin. On unspecified day in Nov-2008, she developed joint pain. On not reported date, she developed sits in wheelchair cannot manage much so her day is lying in bed, sofa and on toilet and go to physiotherapy. The HA received the case from the Patient Insurance Company (PIC) in the form of the patient''s claim. PIC has not yet made a decision in the matter. The patient has been on sick leave since 22-May-2014. Through the municipality, she has received a rehabilitation progression that lasts until Sep-2020. The case is serious due to seriousness criteria hospitalization and disability. No other medications. No information on medical history provided. At the time of reporting, the outcome was unknown for the reaction joint pain. The patient had not recovered from the other reactions.


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