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This is VAERS ID 619725

Case Details

VAERS ID: 619725 (history)  
Age: 13.0  
Gender: Female  
Location: Foreign  
Vaccinated:2008-10-28
Onset:0000-00-00
Submitted: 2015-12-24
Entered: 2015-12-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Alopecia, Arthralgia, Cognitive disorder, Dizziness, Dyskinesia, Dyspnoea, Fatigue, Headache, Hyperacusis, Hyperventilation, Infection, Influenza like illness, Loss of personal independence in daily activities, Menstrual disorder, Muscular weakness, Myalgia, Nausea, Orthostatic intolerance, Palpitations, Photophobia, Skin disorder, Sleep disorder, Tilt table test positive, Vascular malformation, Vomiting, Weight decreased
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Congenital, familial and genetic disorders (narrow), Dyskinesia (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Cardiomyopathy (broad), Corneal disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Hearing impairment (narrow), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Human papillomavirus immunisation; Influenza immunisation
Preexisting Conditions: 03/2008-05/2008, Infectious mononucleosis, Kyssesyge
Diagnostic Lab Data: On an unspecified date, tilt table test at hospital is orthostatic intolerance seen (dysautonom reaction to position change and possible dysfunctional peripheral vasoconstriction) the patient had not postural orthostatic tachycardia syndrome (POTS). The patient experienced weight loss in 2008.
CDC Split Type: WAES1512DNK012120

Write-up: Information has been received from Sanofi Pasteur MSD (SPMSD) (manufacturer control # DK-1577272925-2015001355) on 23-DEC-2015. Case received from a physician via health authority on 21-DEC-2015 under reference number DK-DKMA-WBS-0002112 and DK-DKMA-ADR 23278874. A 13-year-old female adolescent patient received GARDASIL (batch number unknown) via intramuscular route on 28-OCT-2008, GARDASIL (batch number unknown) via intramuscular route on 29-JAN-2009, GARDASIL (batch number unknown) via intramuscular route on 10-JUN-2009. The patient received concomitant administration of Influenza vaccine 1 DF in 2009 between GARDASIL dose 2 and 3. The patient experienced weight loss in 2008, flu like symptoms in 2008, fatigue in 2008, headache on an unknown date, muscle pain on an unknown date, joint pain on an unknown date, dizziness on an unknown date, palpitation on an unknown date, nausea on an unknown date, skin disorder on an unknown date, hair loss on an unknown date, shortness of breath on an unknown date, menstrual disorder on an unknown date, hyperventilation on an unknown date, sleep disorder on an unknown date, cognitive disorder on an unknown date, involuntary muscle movement on an unknown date, limb weakness on an unknown date, light sensitivity to eye on an unknown date, sound sensitivity increased on an unknown date, vascular abnormalities on an unknown date, often infections on an unknown date, vomiting in 2008 and orthostatic intolerance (dysautonom reaction to position change and possible dysfunctional peripheral vasoconstriction) on an unknown date. The first symptoms were flu like symptoms and severe tiredness. She often got infections. Afterwards the other reported reactions. Tilt table test at hospital was orthostatic intolerance seen (dysautonom reaction to position change and possible dysfunctional peripheral vasoconstriction). The patient had not postural orthostatic tachycardia syndrome (POTS). The patient described that due to her symptoms had difficulties manage social events. Other medicines were unknown. The patient had a medical history of infectious mononucleosis in March 2008 from March 2008 to May 2008. The patient''s outcome was reported as not recovered/not resolved. The agency considered the events to be serious due to disability.


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