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This is VAERS ID 620838

Case Details

VAERS ID: 620838 (history)  
Form: Version 1.0  
Age:   
Gender: Female  
Location: Foreign  
Vaccinated:2012-10-03
Onset:0000-00-00
Submitted: 2016-01-19
Entered: 2016-01-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Asthenia, Chest pain, Fatigue, Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

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:
Allergies:
Diagnostic Lab Data:
CDC Split Type: WAES1601IRL005900

Write-up: Information has been received from Sanofi Pasteour (MSD) (case report number IE-1577272925-2016000215) as part of a business agreement on 15-JAN-2016. This case was received from the health authority on 13-Jan-2016. Initial report was received by the HA on 16/Dec/2015 from a Community Care Doctor concerning a female patient who experienced chest pain, fatigue, asthenia and palpitations and following vaccination with GARDASIL. Concomitant medications, if any, were not reported. The patient''s mother reported to the community care doctor that the patient had been well prior to vaccination. The patient was vaccinated with GARDASIL (lot numbers H008259, H008259, expiration date not reported and lot number H013137, expiration date 31-MAR-2015) (corrected on 15-JAN-2016) at unreported doses on 03/Oct/2012, 05/Dec/2012 and 27/Mar/20163. From the end of Oct/2012, the patient developed "chronic chest pain" with fatigue, weakness, anergia and palpitations which the reporter considered to be persistently or significantly disabling/incapacitating. The patient underwent investigations (unspecified) in hospital on 29/Oct/2015 but no explanation for the reactions was determined. At the time of reporting the patient outcome was reported as not recovered/not resolved. Upon internal review, the GARDASIL batch numbers reported by the HA as :HO08259, HO08259, HO13137" have been corrected as H008259, H008259, H013137.


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