National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 620746

Case Details

VAERS ID: 620746 (history)  
Form: Version 1.0  
Age: 14.0  
Gender: Female  
Location: Foreign  
Submitted: 2016-01-19
   Days after onset:1224
Entered: 2016-01-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Abdominal pain, Decreased appetite, Depression, Fatigue
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (narrow)

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:
CDC Split Type: WAES1601IRL005248

Write-up: Information has been received from Sanofi Pasteur MSD (manufacturer number# IE-1577272925-2016000210 on 15-JAN-2016. This case was received from the health authority on 13-Jan-2016. Initial report was received by the HA on 14-DEC-2015 from a Community Pharmacist concerning a 14 year old female patient who experienced decreased appetite, depression, abdominal pain and fatigue following vaccination with GARDASIL. The patient was not receiving any concomitant medications. The patient''s medical history/concurrent conditions were not reported. The patient was vaccinated with three doses of GARDASIL (lot numbers # also reported as "GO19345", "HO08259", "HO13055") intramuscularly between 12/Sep/2012 and 06/Jun/2013. On 12/Sep/2012, the patient developed anorexia, depression, abdominal pain and fatigue which the reporter considered to be persistently or significantly disabling/incapacitating. The events was also considered to be medically significant. At the time of reporting the patient outcome was reported as not recovered/not resolved. Lot numbers # G019345, H008259 and H013055 are valid on 18-JAN-2016.

New Search

Link To This Search Result:

Copyright © 2018 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166