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This is VAERS ID 619360

Case Details

VAERS ID: 619360 (history)  
Form: Version 1.0  
Age: 13.0  
Gender: Female  
Location: Foreign  
Submitted: 2015-12-09
Entered: 2015-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Abdominal pain, Amnesia, Asthenia, Chest pain, Chronic fatigue syndrome, Disturbance in attention, Disturbance in social behaviour, Fatigue, Feeling abnormal, Headache, Influenza like illness, Insomnia, Loss of personal independence in daily activities, Menstrual disorder, Pain in extremity, Photophobia, Post viral fatigue syndrome, Postural orthostatic tachycardia syndrome, Salt craving, Temperature intolerance, Urinary tract disorder
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Drug abuse and dependence (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Glaucoma (broad), Cardiomyopathy (broad), Corneal disorders (broad), Retinal disorders (broad), Depression (excl suicide and self injury) (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Dehydration (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: MEBEVERINE; mefenamic acid; acetaminophen
Current Illness: Immunisation; Menstrual disorder; Irritable bowel syndrome
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1512GBR004142

Write-up: Information has been received from Sanofi Pasteur MSD (manufacturer control number # 2015000245) as part of business agreement on 07-DEC-2015. Case received from a consumer/other non-health professional on 03-DEC-2015 under the report ref number 23247195. A 13-year-old female adolescent patient received GARDASIL, (batch number unknown) on an unknown date. Other suspect products included: MEBEVERINE, (batch number unknown) on an unknown date; Mefenamic Acid, (batch number unknown) on an unknown date; Paracetamol, (batch number unknown) on an unknown date. The patient experienced myalgic encephalomyelitis on an unknown date, abdominal cramps on an unknown date, chest pain on an unknown date, chronic fatigue syndrome on an unknown date, concentration loss on an unknown date, disorder urinary tract on an unknown date, energy decreased on an unknown date, fatigue on an unknown date, flu like symptoms on an unknown date, brain fog on an unknown date, headaches on an unknown date, sensitive to heat on an unknown date, insomnia on an unknown date, memory loss on an unknown date, problem periods on an unknown date, limb pain on an unknown date, sensitive to light on an unknown date and salt craving on an unknown date. Myalgic encephalomyelitis/chronic fatigue syndrome is main diagnosis to date. Patient has postural orthostatic tachycardia but she needs to have a tilt table to discover if this correct. Her life has changed from an outgoing child who attends school daily and had a social life with a large group of friends. She had been doing ballet since the age of 3 years and was at grade 4 on the Celtic harp. She now rarely leaves her bedroom or the house and has very little social life, most of the time none and she no longer does any of her after school activities. She finds taking a hot shower or bath makes her feel worse and is sensitive to light and heat. She loved reading and can no longer concentrate to read. She has always excelled in school but now does not have the physical or mental energy for it. Seek advice details: We have been back and forth to the doctors for the past 3 years and 5 months ago finally managed to see a specialist in pediatrics who diagnosed myalgic encephalomyelitis/chronic fatigue syndrome. There is no treatment for this. Upon internal review the company judged relevant to code POTS which was reported by the HA in their narrative but not coded. The patient''s outcome was reported as Not Recovered/Not Resolved.

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