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This is VAERS ID 619484

History of Changes from the VAERS Wayback Machine

First Appeared on 5/14/2017

619484
VAERS Form:
Age:14.0
Gender:Female
Location:Foreign
Vaccinated:2014-11-26
Onset:0000-00-00
Submitted:2015-12-14
Entered:2015-12-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. H013055 / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Malaise, Pain, Rheumatoid factor positive, Post viral fatigue syndrome, Loss of personal independence in daily activities

Life Threatening? Yes
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: CIRCADIN; gabapentin; melatonin; acetaminophen (+) codeine phosphate; Amitriptyline Hydrochloride; ibuprofen
Current Illness: Immunisation
Preexisting Conditions: Rheumatoid factor positive, Persistance presence of a positive high rheumatoid factor in recent blood tests; Hypersensitivity
Allergies:
Diagnostic Lab Data: Rheumatoid factor (ate not provided):positive; Weight (2014): under 6.5 stone
CDC 'Split Type': WAES1512GBR005584

Write-up:This spontaneous report as received from a patient''s mother via Agency (ADR 23256758) refers to a 14 year old female patient. The patient''s medical history included hypersensitivity and rheumatoid factor positive. On 26-NOV-2014, the patient was vaccinated with a dose of quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (manufacturer unknown) lot # H013055 (expiration date and dose were not reported), parenteral for human papilloma virus immunization. Concomitant therapies included CIRCADIN, gabapentin, melatonin, acetaminophen, co-codamol, amitriptyline hydrochloride (manufacturer unknown) and ibuprofen. On an unknown date, the patient experience myalgic encephalomyelitis, chronic pain and generalized illness. The patient was unable to get of bed, she stopped school, learning and everyday activities. On an unknown date, the patient was hospitalized (reported as "is no in full-time hospital"). Lab diagnostic studies showed persistence presence of a positive high rheumatoid factor in recent blood tests. The outcome of adverse events was reported as not recovered. The relatedness between adverse events and quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine)manufacturer unknown) was not reported. The reported considered events of myalgic encephalomyelitis, chronic pain and generalized illness as medically significant, life threatening and disability. Additional information is not expected since no further follow up information can be obtained from Local Health Authority. Agency narrative: My daughter had no experienced myalgic encephalomyelitis after taking the vaccination, she is very ill and is now in full-time hospital. My daughter had hypersensitivity and was at a weight which was under 6.5 stone, which seems dangerous to give the vaccine. She is unable to get of bed, stopped school and learning, everyday activities have stopped. Her body is now at the age of an old woman. Chronic pain.


Changed on 9/14/2017

619484 Before After
VAERS Form:(blank) 1
Age:14.0
Gender:Female
Location:Foreign
Vaccinated:2014-11-26
Onset:0000-00-00
Submitted:2015-12-14
Entered:2015-12-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. H013055 / - UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Malaise, Pain, Rheumatoid factor positive, Post viral fatigue syndrome, Loss of personal independence in daily activities

Life Threatening? Yes
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: CIRCADIN; gabapentin; melatonin; acetaminophen (+) codeine phosphate; Amitriptyline Hydrochloride; ibuprofen
Current Illness: Immunisation
Preexisting Conditions: Rheumatoid factor positive, Persistance presence of a positive high rheumatoid factor in recent blood tests; Hypersensitivity
Allergies:
Diagnostic Lab Data: Rheumatoid factor (ate not provided):positive; Weight (2014): under 6.5 stone
CDC 'Split Type': WAES1512GBR005584

Write-up:This spontaneous report as received from a patient''s mother via Agency (ADR 23256758) refers to a 14 year old female patient. The patient''s medical history included hypersensitivity and rheumatoid factor positive. On 26-NOV-2014, the patient was vaccinated with a dose of quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (manufacturer unknown) lot # H013055 (expiration date and dose were not reported), parenteral for human papilloma virus immunization. Concomitant therapies included CIRCADIN, gabapentin, melatonin, acetaminophen, co-codamol, amitriptyline hydrochloride (manufacturer unknown) and ibuprofen. On an unknown date, the patient experience myalgic encephalomyelitis, chronic pain and generalized illness. The patient was unable to get of bed, she stopped school, learning and everyday activities. On an unknown date, the patient was hospitalized (reported as "is no in full-time hospital"). Lab diagnostic studies showed persistence presence of a positive high rheumatoid factor in recent blood tests. The outcome of adverse events was reported as not recovered. The relatedness between adverse events and quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine)manufacturer unknown) was not reported. The reported considered events of myalgic encephalomyelitis, chronic pain and generalized illness as medically significant, life threatening and disability. Additional information is not expected since no further follow up information can be obtained from Local Health Authority. Agency narrative: My daughter had no experienced myalgic encephalomyelitis after taking the vaccination, she is very ill and is now in full-time hospital. My daughter had hypersensitivity and was at a weight which was under 6.5 stone, which seems dangerous to give the vaccine. She is unable to get of bed, stopped school and learning, everyday activities have stopped. Her body is now at the age of an old woman. Chronic pain.


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