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This is VAERS ID 629804

Case Details

VAERS ID: 629804 (history)  
Age: 15.0  
Gender: Female  
Location: Wisconsin  
Vaccinated:2013-07-22
Onset:2013-07-24
   Days after vaccination:2
Submitted: 2016-03-29
   Days after onset:979
Entered: 2016-03-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. J003727 / 0 LA / IM

Administered by: Unknown       Purchased by: Private
Symptoms: Amenorrhoea, Anti-Muellerian hormone level, Autonomic nervous system imbalance, Contusion, Dizziness, Fatigue, Headache, Hypoaesthesia, Menstrual disorder, Muscle spasms, Mydriasis, Pain, Pallor, Paraesthesia, Postural orthostatic tachycardia syndrome, Tilt table test
SMQs:, Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Vestibular disorders (broad), Fertility disorders (broad), Hypotonic-hyporesponsive episode (broad)

Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: giant urticaria, petechiae, epistaxis, achiness, malaise, fatigue~Varicella (Varivax)~2~10.83~Patient|fatigue, achiness, develop
Other Medications: fexofenedene for seasonal allergies and reactions to insect stings/bites Sibling received the IPV and DTaP in separate injections. He also experienced previous and subsequent vaccine reactions but my session is about to time out.
Current Illness: No known illness at the time of the vaccination.
Preexisting Conditions: Seasonal allergies, possible hyper mobility, previous immediate vaccine reaction to varicella booster(giant urticaria followed by petechiae, nose bleeds, fatigue and achiness lasting for months)
Diagnostic Lab Data: AMH levels and tilt table testing and full assessment available upon request.
CDC Split Type:

Write-up: Increased bruising noted. 8/2013 greatly decreased menstrual bleeding noted after 3 years of regular periods. Also noticed episodic dizziness and feeling faint, fatigue, generalized achiness, dilated pupils, HAs. 9/2013 Severe muscle spasm and episodic dizziness, HAs, dilated pupils continue. Menstrual period very very light, again. 10/23/2013 HPV #2 given. 11/2013 amenorrhea. Began to notice periods of facial and extremity duskiness and pallor along with above symptoms. Numbness and tingling also noted. 12/2013 AMH (antimullerian hormone which indicates ovarian reserve) is found to be similar to perimenopausal woman. Amenorrhea continues along with other symptoms. 6 through 8/2014 diagnosed with POTS/Dysautonomia.


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