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This is VAERS ID 620408

History of Changes from the VAERS Wayback Machine

First Appeared on 5/14/2017

VAERS ID: 620408
Age:13.0
Gender:Female
Location:Foreign
Vaccinated:2011-04-05
Onset:0000-00-00
Submitted:2015-12-30
Entered:2015-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. NM31130 / 2 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Systemic lupus erythematosus

Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1512IRL013530

Write-up:Information has been received from Sanofi Pasteur MSD (reference No. IE-1577272925-2015001488) as a part of a business agreement on 28-DEC-2015. This case was received from the RA health authority on 23-DEC-2015 with reference number IE-HPRA-2015-025495. Initial report was received by the RA on 11/Dec/2015 from a member of the public which concerns a 13 year old Female patient who was diagnosed with Systemic lupus erythematosus following vaccination with GARDASIL. Concomitant medications: None. Medical history/concurrent conditions: None. The patient was vaccinated with 3 doses of GARDASIL at a dose of 0.5 ml via IV route between 13/Sep/2010 and 05/Apr/2011. Only one batch/lot number was provided - NM31130 (expiration date was not reported). 7 months post last dose, in Sep/2011, the patient was diagnosed with lupus (SLE). Corrective treatment: Prednisolone, azathioprine and PLAQUENIL. At the time of reporting the patient''s symptoms were ongoing. The patient outcome is not recovered/not resolved.


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