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This is VAERS ID 629492

History of Changes from the VAERS Wayback Machine

First Appeared on 3/14/2017

629492
VAERS Form:
Age:13.0
Gender:Female
Location:Foreign
Vaccinated:2015-11-05
Onset:0000-00-00
Submitted:2016-02-18
Entered:2016-02-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Arthralgia, Asthenia, Headache, Malaise, Pyrexia, Decreased appetite

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Immunisation
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES1602IRL007811

Write-up:Information has been received from Sanofi Pasteur MSD (MRF: IE-1577272925-20160012270) on 15-FEB-2016. This case was received from the health authority on 15-Feb-2016. Ref IE-HPRA-2016-025874. Initial report was received by the RA on 31/Jan/2016 from a member of the public which concerns a 13 year old female patient who experienced Malaise, Arthralgia, Pyrexia, Headache and Decreased appetite following vaccination with GARDASIL. Concomitant medications: Diphtheria Tetanus and Pertussis vaccine (brand unspecified) given on 05/11/2015. Medical history/concurrent conditions: Nil. Previously a very healthy child. The patient was vaccinated with GARDASIL via IM route on 05/Nov/2015. Post vaccination; the patient became very unwell on 07/Nov/2015, presented with achy joints and high temperature on 08/Nov/2015. She felt very weak, also headache, and no appetite.. The reported indicated that the patient was in bed for 7 days and all sporting activity was curtailed for 1 month following this reaction. Corrective treatment: Analgesia and bed rest. At the time of reporting the patient had made a complete recovery. Upon internal review the vaccine DTP was considered to be suspect.


Changed on 9/14/2017

629492 Before After
VAERS Form:(blank) 1
Age:13.0
Gender:Female
Location:Foreign
Vaccinated:2015-11-05
Onset:0000-00-00
Submitted:2016-02-18
Entered:2016-02-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UNK UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Arthralgia, Asthenia, Headache, Malaise, Pyrexia, Decreased appetite

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Immunisation
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES1602IRL007811

Write-up:Information has been received from Sanofi Pasteur MSD (MRF: IE-1577272925-20160012270) on 15-FEB-2016. This case was received from the health authority on 15-Feb-2016. Ref IE-HPRA-2016-025874. Initial report was received by the RA on 31/Jan/2016 from a member of the public which concerns a 13 year old female patient who experienced Malaise, Arthralgia, Pyrexia, Headache and Decreased appetite following vaccination with GARDASIL. Concomitant medications: Diphtheria Tetanus and Pertussis vaccine (brand unspecified) given on 05/11/2015. Medical history/concurrent conditions: Nil. Previously a very healthy child. The patient was vaccinated with GARDASIL via IM route on 05/Nov/2015. Post vaccination; the patient became very unwell on 07/Nov/2015, presented with achy joints and high temperature on 08/Nov/2015. She felt very weak, also headache, and no appetite.. The reported indicated that the patient was in bed for 7 days and all sporting activity was curtailed for 1 month following this reaction. Corrective treatment: Analgesia and bed rest. At the time of reporting the patient had made a complete recovery. Upon internal review the vaccine DTP was considered to be suspect.


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