National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 628873

History of Changes from the VAERS Wayback Machine

First Appeared on 4/14/2017

VAERS ID: 628873
Age:15.0
Gender:Female
Location:Foreign
Vaccinated:2009-07-30
Onset:0000-00-00
Submitted:2016-02-09
Entered:2016-02-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. NJ34850 / 2 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Alopecia, Anxiety, Arthralgia, Asthenia, Depression, Disturbance in attention, Dizziness, Dysaesthesia, Echocardiogram, Electrocardiogram ambulatory, Fatigue, Headache, Hypertension, Nausea, Nuclear magnetic resonance imaging, Pallor, Palpitations, Rash, Rash erythematous, Stress, Tinnitus, Vomiting, Weight decreased, Tilt table test, Gastrointestinal motility disorder, Decreased appetite, Blood test

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: Immunisation
Preexisting Conditions: Hypermobility syndrome
Diagnostic Lab Data: MR scanning, blood test, tilt table test, ECHO, Holter monitoring 24 h, blood pressure measurement
CDC 'Split Type': WAES1602DNK004545

Write-up:Information has been received from Sanofi Pasteur MSD [DK-1577272925-2016000881] on 08-FEB-2016. Case received from a physician via health authority on 04-FEB-2016 under reference number DK-DKMA-WBS-0002590. A 15-year-old female adolescent patient received GARDASIL (batch number unknown dose 1) via intramuscular route on 05-JAN-2009, GARDASIL (batch number unknown, Dose 2) via intramuscular route on 04-MAR-2009, GARDASIL (batch number NJ34850, Dose 3) via intramuscular route on 30-JUL-2009. The patient experienced depression on an unknown date, memory problems in 2012, anxiety on an unknown date, concentration problems in 2012, hair loss in 2013, Tinnitus in 2013, stress on an unknown date, pale in mouth in 2013, rash, red patches on chest and knobs in face in 2013, Hypertension in 2015, weight loss in 2010, nausea in 2010, joint pain in MAR-2009, tiredness in 2011, vomiting in 2010, alternating stool in 2011, palpation in 2011, dizziness in 2011, dysesthesia in 2011, reduced appetite in 2010, headache in April 2009 and loss of energy in 2011. Has been confirmed with anxiety, stress and depression and have been at centrum for functional disorders with severe Bodily distress syndrome (BDS). Investigations: MR scanning, blood test, tilt table test, ECHO, Holter monitoring 24 h, blood pressure measurement. The patient had a medical history of Hypermobility syndrome. No other vaccines or medicines. The patient''s outcome was reported as recovering for rash, nausea, reduced appetite and weight loss and Not Recovered/Not Resolved for the other reported reaction.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=628873&WAYBACKHISTORY=ON


Copyright © 2017 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166