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This is VAERS ID 620173

History of Changes from the VAERS Wayback Machine

First Appeared on 5/14/2017

620173
VAERS Form:
Age:15.0
Gender:Female
Location:Foreign
Vaccinated:2009-03-24
Onset:0000-00-00
Submitted:2015-12-23
Entered:2015-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. NJ38950 / 1 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Arthralgia, Constipation, Diarrhoea, Dizziness, Dyspnoea, Dysuria, Fatigue, Headache, Hyperventilation, Menorrhagia, Muscle spasms, Pain in extremity, Presyncope, Stress, Vision blurred, Cognitive disorder, Temperature regulation disorder, Tilt table test normal, Loss of personal independence in daily activities

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Human papilloma virus immunisation
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: A tilt table test showed normal condition.
CDC 'Split Type': WAES1512DNK011672

Write-up:Information has been received from Sanofi Pasteur MSD (MFR Control number DK-1577272925-2015001199) on 22-DEC-2015. Case received from a physician on 17-DEC-2015. A female adolescent patient of unknown age received GARDASIL, batch number unknown, Dose 1 via intramuscular route on 20-JAN-2009. Other suspect products included GARDASIL, batch/lot number unknown, Dose 2 administered via intramuscular route on 24-MAR-2009. The patient experienced Headache on an unknown date, Knee pain on an unknown date, Pain feet on an unknown date, Dizziness on an unknown date, Near syncope on an unknown date, Abdominal pain on an unknown date, Abdominal cramp on an unknown date, Obstipation on an unknown date, Diarrhea on an unknown date, Voiding difficulty on an unknown date, Dyspnoea on an unknown date, Menses regular with excessive bleeding on an unknown date, Hyperventilation on an unknown date, Fatigue / tired on an unknown date, Cognitive disturbance on an unknown date, Cramps on an unknown date, Stress in 2014, Temperature regulation disorder on an unknown date and Blurred vision on an unknown date. No other vaccines or medicines: unknown. Patient received two doses vaccine in the beginning of 2009, at 14/15-year-old. In ninth grade, patient experienced symptoms such as dizziness, sore knees, severe headache and was very tired. Subsequently, other reported symptoms develops. A tilt table test at the department show normal. Patient describes that she has been forced to abandon her education program. Has social assistance. Stress for a long period in 2014.


Changed on 9/14/2017

620173 Before After
VAERS Form:(blank) 1
Age:15.0
Gender:Female
Location:Foreign
Vaccinated:2009-03-24
Onset:0000-00-00
Submitted:2015-12-23
Entered:2015-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. NJ38950 / 1 2 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Arthralgia, Constipation, Diarrhoea, Dizziness, Dyspnoea, Dysuria, Fatigue, Headache, Hyperventilation, Menorrhagia, Muscle spasms, Pain in extremity, Presyncope, Stress, Vision blurred, Cognitive disorder, Temperature regulation disorder, Tilt table test normal, Loss of personal independence in daily activities

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Human papilloma virus immunisation
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: A tilt table test showed normal condition.
CDC 'Split Type': WAES1512DNK011672

Write-up:Information has been received from Sanofi Pasteur MSD (MFR Control number DK-1577272925-2015001199) on 22-DEC-2015. Case received from a physician on 17-DEC-2015. A female adolescent patient of unknown age received GARDASIL, batch number unknown, Dose 1 via intramuscular route on 20-JAN-2009. Other suspect products included GARDASIL, batch/lot number unknown, Dose 2 administered via intramuscular route on 24-MAR-2009. The patient experienced Headache on an unknown date, Knee pain on an unknown date, Pain feet on an unknown date, Dizziness on an unknown date, Near syncope on an unknown date, Abdominal pain on an unknown date, Abdominal cramp on an unknown date, Obstipation on an unknown date, Diarrhea on an unknown date, Voiding difficulty on an unknown date, Dyspnoea on an unknown date, Menses regular with excessive bleeding on an unknown date, Hyperventilation on an unknown date, Fatigue / tired on an unknown date, Cognitive disturbance on an unknown date, Cramps on an unknown date, Stress in 2014, Temperature regulation disorder on an unknown date and Blurred vision on an unknown date. No other vaccines or medicines: unknown. Patient received two doses vaccine in the beginning of 2009, at 14/15-year-old. In ninth grade, patient experienced symptoms such as dizziness, sore knees, severe headache and was very tired. Subsequently, other reported symptoms develops. A tilt table test at the department show normal. Patient describes that she has been forced to abandon her education program. Has social assistance. Stress for a long period in 2014.


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