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This is VAERS ID 620303

History of Changes from the VAERS Wayback Machine

First Appeared on 5/14/2017

620303
VAERS Form:
Age:12.0
Gender:Female
Location:Foreign
Vaccinated:2012-04-26
Onset:2012-05-01
Submitted:2015-12-28
Entered:2015-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Arthralgia, Dizziness, Dyskinesia, Dyspnoea, Dysuria, Fatigue, Headache, Hyperhidrosis, Hyperventilation, Influenza like illness, Menstruation irregular, Muscle spasms, Muscular weakness, Nausea, Photophobia, Sleep disorder, Syncope, Vision blurred, Cognitive 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)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: HPV immunisation; Immunisation
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: during tilt table test the patient does not fulfill the diagnostic criteria for POTS.
CDC 'Split Type': WAES1512DNK011882

Write-up:Information has been received from Sanofi Pasteur MSD (MFR # 2015001354) on 23-DEC-2015. Flu like symptoms, Dizziness, Headache, Fatigue extreme, Involuntary muscle movement, Joint pain, Nausea, Abdominal pain, Dyspnoea, Irregular menstruation, Hyperventilation, Sleep disorder, Blurred vision, Sweating abnormal, Cramps, Recurrent syncope, Voiding dysfunction, Cognitive dysfunction, Limb weakness, Light sensitivity to eyes. Case received from a physician via health authority on 21-Dec-2015 under reference number DK-DKMA-WBS-0002070 and DK-DKMA-ADR 23279872. A 12-year-old female adolescent patient received GARDASIL, (batch number unknown) via intramuscular route on 26-Apr-2012, GARDASIL, (batch number unknown) via intramuscular route on 03-Jul-2012, GARDASIL, (batch number unknown) via intramuscular route on 03-Apr-2013. The patient received concomitant administration of PRIORIX 1 DF on an unknown date. The patient experienced Flu like symptoms in MAY-2012/1 Weeks post injection, Dizziness in MAY-2012/1 Weeks post injection, Headache in MAY-2012/1 Weeks post injection, Fatigue extreme in MAY-2012/1 Weeks post injection, Involuntary muscle movement on an unknown date, Joint pain on an unknown date, Recurrent syncope on an unknown date, Nausea on an unknown date, Abdominal pain on an unknown date, Voiding dysfunction on an unknown date, Dyspnoea on an unknown date, Irregular menstruation on an unknown date, Hyperventilation on an unknown date, Sleep disorder on an unknown date, Cognitive dysfunction on an unknown date, Limb weakness on an unknown date, Sleep disorder on an unknown date, Cognitive dysfunction on an unknown date, Limb weakness on an unknown date, Blurred vision on an unknown date, Sweating abnormal on an unknown date, Light sensitivity to eyes on an unknown date, Cramps on an unknown date and reduced function on an unknown date. 7 days later first dose flu like symptoms, headache, dizziness and tiredness. Afterwards the other reported symptoms. During tilt table test she does no fulfill the diagnostic criteria for POTS. The patient describes reduced function and has a lot of sick leave from school (class 6 to 9). The patient was admitted to hospital on an unspecified date. The patient''s outcome was reported as Not Recovered/Not Resolve.


Changed on 9/14/2017

620303 Before After
VAERS Form:(blank) 1
Age:12.0
Gender:Female
Location:Foreign
Vaccinated:2012-04-26
Onset:2012-05-01
Submitted:2015-12-28
Entered:2015-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 1 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Arthralgia, Dizziness, Dyskinesia, Dyspnoea, Dysuria, Fatigue, Headache, Hyperhidrosis, Hyperventilation, Influenza like illness, Menstruation irregular, Muscle spasms, Muscular weakness, Nausea, Photophobia, Sleep disorder, Syncope, Vision blurred, Cognitive 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)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: HPV immunisation; Immunisation
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: during tilt table test the patient does not fulfill the diagnostic criteria for POTS.
CDC 'Split Type': WAES1512DNK011882

Write-up:Information has been received from Sanofi Pasteur MSD (MFR # 2015001354) on 23-DEC-2015. Flu like symptoms, Dizziness, Headache, Fatigue extreme, Involuntary muscle movement, Joint pain, Nausea, Abdominal pain, Dyspnoea, Irregular menstruation, Hyperventilation, Sleep disorder, Blurred vision, Sweating abnormal, Cramps, Recurrent syncope, Voiding dysfunction, Cognitive dysfunction, Limb weakness, Light sensitivity to eyes. Case received from a physician via health authority on 21-Dec-2015 under reference number DK-DKMA-WBS-0002070 and DK-DKMA-ADR 23279872. A 12-year-old female adolescent patient received GARDASIL, (batch number unknown) via intramuscular route on 26-Apr-2012, GARDASIL, (batch number unknown) via intramuscular route on 03-Jul-2012, GARDASIL, (batch number unknown) via intramuscular route on 03-Apr-2013. The patient received concomitant administration of PRIORIX 1 DF on an unknown date. The patient experienced Flu like symptoms in MAY-2012/1 Weeks post injection, Dizziness in MAY-2012/1 Weeks post injection, Headache in MAY-2012/1 Weeks post injection, Fatigue extreme in MAY-2012/1 Weeks post injection, Involuntary muscle movement on an unknown date, Joint pain on an unknown date, Recurrent syncope on an unknown date, Nausea on an unknown date, Abdominal pain on an unknown date, Voiding dysfunction on an unknown date, Dyspnoea on an unknown date, Irregular menstruation on an unknown date, Hyperventilation on an unknown date, Sleep disorder on an unknown date, Cognitive dysfunction on an unknown date, Limb weakness on an unknown date, Sleep disorder on an unknown date, Cognitive dysfunction on an unknown date, Limb weakness on an unknown date, Blurred vision on an unknown date, Sweating abnormal on an unknown date, Light sensitivity to eyes on an unknown date, Cramps on an unknown date and reduced function on an unknown date. 7 days later first dose flu like symptoms, headache, dizziness and tiredness. Afterwards the other reported symptoms. During tilt table test she does no fulfill the diagnostic criteria for POTS. The patient describes reduced function and has a lot of sick leave from school (class 6 to 9). The patient was admitted to hospital on an unspecified date. The patient''s outcome was reported as Not Recovered/Not Resolve.


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