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This is VAERS ID 620746

History of Changes from the VAERS Wayback Machine

First Appeared on 4/14/2017

VAERS ID: 620746
Age:14.0
Gender:Female
Location:Foreign
Vaccinated:0000-00-00
Onset:2012-09-12
Submitted:2016-01-19
Entered:2016-01-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Depression, Fatigue, Decreased appetite

Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? 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.


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