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This is VAERS ID 620107

Case Details

VAERS ID: 620107 (history)  
Age: 13.0  
Gender: Female  
Location: Foreign  
Submitted: 2015-12-23
Entered: 2015-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Dizziness, Exercise tolerance decreased, Orthostatic intolerance, Presyncope, Tilt table test positive
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (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: HPV immunisation
Preexisting Conditions:
Diagnostic Lab Data: A tilt table test at the department (unknown date): showed orthostatic intolerance, but the patient does not fulfill the diagnostic criteria for POTS
CDC Split Type: WAES1512DNK010892

Write-up: Information has been received from Sanofi Pasteur MSD (manufacturer control number # 2015001188) as part of business agreement on 21-DEC-2015. Case received from a physician on 17-DEC-2015. A 13-year-old female adolescent patient received GARDASIL, (batch number unknown) via intramuscular route on 14-Apr-2010. Other suspect products included: Gardasil, (batch number unknown, Dose 2) administered via intramuscular route on 16-Jun-2010 -GARDASIL, (batch number unknown , Dose 3) administered via intramuscular route on 13-Dec-2010. The patient experienced Near syncope in DEC-2010, Dizziness in DEC-2010 and Exercise capacity decreased on an unknown date. Additional investigations included Tilt Table Test orthostatic intolerance n/a on an unknown date.Other HA comment: A tilt table test at the department showed orthostatic intolerance, but the patient does not fulfill the diagnostic criteria for POTS. Other medicines/and vaccines: unknown. 6 months after dose 2 of GARDASIL the patient attends a basketball tournament and get near syncope, then experience it several times with dizziness. Physical activity significantly reduced now.

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