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This is VAERS ID 619741

Case Details

VAERS ID: 619741 (history)  
Form: Version 1.0  
Age: 14.0  
Gender: Female  
Location: Foreign  
Submitted: 2015-12-24
Entered: 2015-12-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Abdominal pain, Chest pain, Constipation, Diarrhoea, Dizziness, Dry mouth, Dysuria, Fatigue, Headache, Muscle twitching, Muscular weakness, Myalgia, Nausea, Neuralgia, Palpitations, Postural orthostatic tachycardia syndrome, Presyncope, Skin disorder, Sleep disorder, Tilt table test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Dyskinesia (broad), Dystonia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Noninfectious diarrhoea (narrow), 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? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: HPV immunisation
Preexisting Conditions:
Diagnostic Lab Data: Tilt table test, at Hospital, showed POTS, but with good blood pressure regulation
CDC Split Type: WAES1512DNK011688

Write-up: Information has been received from Sanofi Pasteur MSD (MFR Control number DK-1577272925-2015001272) on 22-DEC-2015. Case received from a physician via HA on 19-Dec-2015, under the reference number DK-DKMA-WBS-0002126 and DK-DKMA-ADR 23278249. A 15-year-old female adolescent patient received GARDASIL, (batch number unknown, Dose 1) via intramuscular route on 28-May-2010, GARDASIL, (batch number unknown, Dose 2) via intramuscular route on 18-Aug-2010, GARDASIL, (batch number unknown, Dose 3) via intramuscular route on 26-Nov-2010. The patient experienced Dizziness in 2012, Headache in 2012, Chest pain on an unknown date, Muscle pain in the arm on an unknown date, Neuropathic pain on an unknown date, Near syncope on an unknown date, Palpitation on an unknown date, Nausea on an unknown date, Abdominal pain on an unknown date, Voiding difficulty on an unknown date, Skin disorder on an unknown date, Sleep disorder on an unknown date, Fatigue on an unknown date, limb weakness on an unknown date, Dry mouth on an unknown date, Diarrhea on an unknown date, Obstipation on an unknown date, twitching in arms in 2012 and POTS on an unknown date. The patient describes that she in 2012 started experiencing dizziness, twitching in arms and headache. Tilt table test, at hospital, showed POTS, but with good blood pressure regulation. The center uses the following criteria to confirm the diagnosis POTS: Heart rate increases greater than or equal to 30 bpm from supine to standing (10 min) in the absence of orthostatic hypotension (decrease in BP greater than 20/10 mmHg). Symptoms worsen with standing and improved with recumbence. Symptoms last greater than or equal to 6 months. Absence of other overt cause of orthostatic symptoms or tachycardia (e.g., active bleeding, acute dehydration, medications) In addition, an additional criteria is used in patients between 12-19 years old: require a pulse increase greater than 40 bpm to confirm the diagnosis, based on that young people have a greater physiological pulse response upon standing up. This additional criterion is used to avoid false positives. Unknown whether there were other vaccines or medications. Dizziness, headache, chest pain, neuropathic pain, near syncope, palpitation, nausea, abdominal pain, voiding difficulty, skin disorder, sleep disorder, fatigue, dry mouth, diarrhea, obstipation, muscle pain in the arm, limb weakness, paresthesia upper limb. Tilt table test, at Hospital, showed POTS, but with good blood pressure regulation. At the time of reporting, the outcome was unknown for the reactions chest pain and twitching in arms. The patient had not recovered from the other reactions.

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