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This is VAERS ID 620274

Case Details

VAERS ID: 620274 (history)  
Form: Version 1.0  
Gender: Female  
Location: Foreign  
Submitted: 2015-12-26
Entered: 2015-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Abdominal distension, Abdominal pain, Acne, Angiopathy, Arthralgia, Cognitive disorder, Constipation, Diarrhoea, Dizziness, Dry eye, Dry mouth, Dyskinesia, Dyspnoea, Dysuria, Eczema, Fatigue, Headache, Hyperhidrosis, Hyperventilation, Loss of consciousness, Muscle spasms, Muscular weakness, Myalgia, Nausea, Palpitations, Photophobia, Pyrexia, Syncope, Tilt table test normal, Vision blurred
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Pseudomembranous colitis (broad), Dyskinesia (narrow), Dystonia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (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), Lens disorders (broad), Corneal disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Vestibular disorders (broad), Conjunctival disorders (narrow), Lacrimal disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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: Unknown
Preexisting Conditions:
Diagnostic Lab Data: Tilt table test (??-??-????): The patient does not fulfill the diagnostic criteria for POTS.
CDC Split Type: WAES1512DNK011489

Write-up: Information has been received from Sanofi Pasteur MSD (SPM) [MFR #DK-1577272925-2015001353] on 22-DEC-2015. Case received from a physician via health authority on 21-DEC-2015 under reference number DK-DKMA-WBS-0002168. A female adolescent patient of unknown age received GARDASIL, (batch number unknown) via intramuscular route in 2009. The patient experienced Syncope/recurrent syncope in 2009, Headache on an unknown date, Muscle pain in arms and legs on an unknown date, Joint pain on an unknown date, Dizziness on an unknown date, Palpitations on an unknown date, Nausea on an unknown date, Abdominal cramps on an unknown date, Voiding dysfunction on an unknown date, Eczema (arms) on an unknown date, Acne on an unknown date, Dyspnoea on an unknown date, Hyperventilation on an unknown date, Fatigue extreme on an unknown date, Cognitive dysfunction on an unknown date, Involuntary muscle movement on an unknown date, Limb weakness on an unknown date, Subfebrilia on an unknown date, Vascular abnormalities on an unknown date, Sweating abnormal on an unknown date, Dry eyes on an unknown date, Dry mouth on an unknown date, Feeling bloated on an unknown date, Diarrhea on an unknown date, Obstipation on an unknown date, Light sensitivity to eyes on an unknown date, Blurred vision on an unknown date, reduced function on an unknown date, loss of consciousness on an unknown date, loss of consciousness preceded by cramps on an unknown date, Eczema (eyes) on an unknown date and a lot sick leave from her education (3/4 on sick leave) on an unknown date. The exact vaccination dates not known (probably 2009) therefore it is not possible to assess the time relationship between the vaccine and the reactions. The first symptom was fainting and started after the second dose. Afterwards the other reported symptoms. During tilt table test the patient did not fulfill the diagnostic criteria for POTS. The patient described loss of consciousness preceding of cramps. She describes reduced function and has a lot of sick leave from her education (3/4 on sick leave) goes to medical exams each time. The patient has received all three doses. Other medicines or vaccines not known. The patient''s outcome was reported as Not Recovered/Not Resolved.

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