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History of Changes from the VAERS Wayback Machine |
First Appeared on 5/14/2017 |
VAERS ID: | 620354 |
VAERS Form: | |
Age: | |
Gender: | Female |
Location: | Foreign |
Vaccinated: | 2011-10-05 |
Onset: | 0000-00-00 |
Submitted: | 2015-12-29 |
Entered: | 2015-12-29 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | AHPVA143DA / 2 | LA / IM |
Administered by: Other Purchased by: Other
Symptoms: Asthenia, Motor dysfunction
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: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': JP2015JPN178875
Write-up: This case was reported by a physician via sales rep and described the occurrence of motor dysfunction in a 20-year-old female subject who received CERVARIX (batch number AHPVA122BA, expiry date unknown), (batch number AHPVA100CA, expiry date unknown) and (batch number AHPVA143DA, expiry date unknown). On 19th March 2011, the subject received the 1st dose of CERVARIX (intramuscular) .5 ml. On 23rd April 2011, the 2nd dose was .5 ml. On 5th October 2011, the 3rd dose was .5 ml. On an unknown date, unknown after receiving CERVARIX, the subject experienced motor dysfunction (serious criteria disability) and weakness generalised (serious criteria disability). On an unknown date, the outcome of the motor dysfunction and weakness generalised were unknown. It was not reported if the reporter considered the motor dysfunction and weakness generalised to be related to CERVARIX.
Vaccinated: | 2011-10-05 |
Onset: | 0000-00-00 |
Submitted: | 2015-12-29 |
Entered: | 2015-12-29 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | AHPVA143DA / 2 3 | LA / IM |
Administered by: Other Purchased by: Other
Symptoms: Asthenia, Motor dysfunction
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: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': JP2015JPN178875
Write-up: This case was reported by a physician via sales rep and described the occurrence of motor dysfunction in a 20-year-old female subject who received CERVARIX (batch number AHPVA122BA, expiry date unknown), (batch number AHPVA100CA, expiry date unknown) and (batch number AHPVA143DA, expiry date unknown). On 19th March 2011, the subject received the 1st dose of CERVARIX (intramuscular) .5 ml. On 23rd April 2011, the 2nd dose was .5 ml. On 5th October 2011, the 3rd dose was .5 ml. On an unknown date, unknown after receiving CERVARIX, the subject experienced motor dysfunction (serious criteria disability) and weakness generalised (serious criteria disability). On an unknown date, the outcome of the motor dysfunction and weakness generalised were unknown. It was not reported if the reporter considered the motor dysfunction and weakness generalised to be related to CERVARIX.
Vaccinated: | 2011-10-05 |
Onset: | 0000-00-00 |
Submitted: | 2015-12-29 |
Entered: | 2015-12-29 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | AHPVA143DA / 3 | LA / IM |
Administered by: Other Purchased by: Other
Symptoms: Asthenia, Motor dysfunction
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: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': JP2015JPN178875
Write-up: This case was reported by a physician via sales rep and described the occurrence of motor dysfunction in a 20-year-old female subject who received CERVARIX (batch number AHPVA122BA, expiry date unknown), (batch number AHPVA100CA, expiry date unknown) and (batch number AHPVA143DA, expiry date unknown). On 19th March 2011, the subject received the 1st dose of CERVARIX (intramuscular) .5 ml. On 23rd April 2011, the 2nd dose was .5 ml. On 5th October 2011, the 3rd dose was .5 ml. On an unknown date, unknown after receiving CERVARIX, the subject experienced motor dysfunction (serious criteria disability) and weakness generalised (serious criteria disability). On an unknown date, the outcome of the motor dysfunction and weakness generalised were unknown. It was not reported if the reporter considered the motor dysfunction and weakness generalised to be related to CERVARIX.
Link To This Search Result:
http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=620354&WAYBACKHISTORY=ON
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