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This is VAERS ID 619780

Case Details

VAERS ID: 619780 (history)  
Age: 12.0  
Gender: Female  
Location: Foreign  
Vaccinated:2012-03-14
Onset:2012-04-01
   Days after vaccination:18
Submitted: 2015-12-18
   Days after onset:1356
Entered: 2015-12-28
   Days after submission:10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Arthralgia, Back pain, Blood electrolytes normal, Disturbance in attention, Fatigue, Gait disturbance, Headache, Hypermobility syndrome, Laboratory test, Liver function test normal, Metabolic function test normal, Musculoskeletal pain, Red blood cell count normal, Ultrasound scan normal, Vitamin D decreased, White blood cell count normal
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Depression (excl suicide and self injury) (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (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 papilloma virus immunisation
Preexisting Conditions:
Diagnostic Lab Data: Have examinations and/or laboratory results been performed: Yes. Normal blood tests: red, white blood picture, metabolism, liver and bladder counts, electrolytes, mildly decreased vitamin D. Confirmed mild hypermobility. Investigated for Ehlers-Danlos. Not found. ECHO normal. Blood count, normal; Blood count, N/A; Ultrasound scan, N/A.
CDC Split Type: WAES1512DNK008886

Write-up: Information has been received from Sanofi Pasteur MSD (MFR control number DK-1577272925-2015000991 on 16-DEC-2015. Case received from a physician via HA on 14-DEC-2015 under the reference number DK-DKMA-WBS-0001994 and DK-DKMA-ADR 23270989. A 12-year-old female adolescent patient received GARDASIL (batch number unknown, Dose 1) in JAN-2012, GARDASIL (batch/lot number unknown, Dose 2) in MAR-2012, GARDASIL (batch number unknown, Dose 3) in JUL-2012. The patient experienced back pain in APR-2012, headache in JUL-2012, tiredness in JUL-2012, Musculoskeletal pain in APR-2012, pain from knees and hips under load in APR-2012, concentration impaired in connection to headache in JUL-2012 and decreased walking distance due to musculoskeletal pain in APR-2012. Have examinations and/or laboratory results been performed: Yes. Normal blood tests: red, white blood; picture metabolism, liver and bladder counts, electrolytes, mildly decreased vitamin D. Confirmed mild hypermobility. Investigated for Ehlers-Danlos. Not found. ECHO normal. The patient has been confirmed with mild hypermobility. No effect from physiotherapy. Giving up on training and physiotherapy. No other medications and vaccines. The case is assessed as serious due to disability. The patient''s outcome was reported as Not Recovered/Not Resolved.


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