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This is VAERS ID 629804

Case Details

VAERS ID: 629804 (history)  
Form: Version 1.0  
Age: 15.0  
Gender: Female  
Location: Wisconsin  
   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 / 1 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), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
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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