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This is VAERS ID 620290

Case Details

VAERS ID: 620290 (history)  
Form: Version 1.0  
Gender: Female  
Location: Foreign  
Submitted: 2015-12-28
Entered: 2015-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Abdominal distension, Abdominal pain, Angiopathy, Cognitive disorder, Constipation, Diarrhoea, Dizziness, Dry eye, Dry mouth, Headache, Hyperhidrosis, Photophobia, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Conjunctival disorders (narrow), Lacrimal disorders (narrow), Noninfectious diarrhoea (narrow), 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: Test or examinations: unknown; Body temperature, fever
CDC Split Type: WAES1512DNK012413

Write-up: Information has been received from Sanofi Pasteur MSD (SPM) [MFR # DK-1577272925-2015001420] on 23-DEC-2015. Case received from a physician via health authority on 22-DEC-2015 under reference number DK-DKMA-WBS-0002122 and DK-DKMA-ADR 23278244. A female adolescent patient of unknown age received GARDASIL (batch number unknown) via intramuscular route on an unknown date. The patient experienced abdominal pain on an unknown date, fever on an unknown date, headache on an unknown date, vascular disorder on an unknown date, cognitive disorder on an unknown date, dizziness on an unknown date, sweating abnormal on an unknown date, dry eyes on an unknown date, dry mouth on an unknown date, bloated feeling on an unknown date, abdominal cramp on an unknown date, diarrhea on an unknown date, obstipation on an unknown date and light sensitivity to eye on an unknown date. Abdominal cramps started after 1 dose with high fever. She has not reported the vaccination dates. The other symptoms afterwards. The patient''s outcome was reported as Not Recovered/Not Resolved. Other vaccines or medicines: Unknown.

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