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This is VAERS ID 629871

Case Details

VAERS ID: 629871 (history)  
Form: Version 1.0  
Age: 12.0  
Gender: Female  
Location: Foreign  
Vaccinated:2010-11-01
Onset:0000-00-00
Submitted: 2016-03-04
Entered: 2016-03-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 3 UN / IM

Administered by: Other       Purchased by: Other
Symptoms: Abdominal pain upper, Allergy test, Alopecia, Arthralgia, Asthenia, Back pain, Blood test, Chills, Discomfort, Disturbance in attention, Dizziness, Dry skin, Dyskinesia, Erythema, Fatigue, Hair texture abnormal, Headache, Hyperhidrosis, Hyperventilation, Hypovitaminosis, Immune system disorder, Insomnia, Myalgia, Nausea, Pain, Pain in extremity, Pallor, Palpitations, Pollakiuria, Rash erythematous, Rash generalised, Sleep disorder
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Dyskinesia (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (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: Human papilloma virus immunisation
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: The patient has been examined by own doctor that has taken blood tests. Without any results. The patient has in addition undergone Vega test that showed that the patient has 60% aluminum in the body and deficiency in virtually all vitamins. In addition, the patient''s energy levels are abnormal, significantly below in relation the patient''s age. The patient''s immune system is only 50%.
CDC Split Type: WAES1603DNK001557

Write-up: Information has been received from Sanofi Pasteur MSD(SPM) with (MFR# DK-1577272925-2015000438) on 02-MAR-2016. Case received from a consumer/other non health professional via HA on 12-NOV-2015 under the reference DK-DKMA-WBS-0001616 and DK-DKMA-ADR 23225253. A 12-year-old female adolescent patient received GARDASIL (batch number unknown, Dose 1) on 09-APR-2010, GARDASIL (batch number unknown) on 01-NOV-2010. The patient experienced chronic tiredness in 2011, Joint pain in 2011, Muscle pain in 2011, Dizziness in 2011, Palpitation in 2011, Nausea in 2011, Headache in 2011 and Concentration impairment in 2011. The patient has not been treated for the adverse reactions. The patient has not been hospitalized due to the adverse reactions. The patient''s outcome was reported as Not Recovered/Not Resolved. Follow up information received from HA on 29-FEB-2016. The HA received a duplicate from the patient''s physician on 22-FEB-2016. The duplicate has not been sent to agency before merging to this master case. Adverse reactions: Hyperventilation, movement problems, pale skin, general feeling of discomfort or illness, hair loss, chills, nausea, joint pain, muscle pain, sudden and severe back pain, red spots on skin/redness on the skin, pain in body, pain in joints, pain in legs and stomach, sleeplessness, sleep problems, dizziness, dry skin, dry hair, rash on body, abnormal tiredness, increased sweating, increased urination. Other vaccines: No. Other medication: No. Added to the case: New adverse reactions are added, all with outcome: Not Recovered/resolved (Hyperventilation in DEC-2012, movement problems on an unknown date, Pale skin on an unknown date, General feeling of discomfort or illness on an unknown date, Hair loss on an unknown date, Chills on an unknown date, Sudden and severe back pain on an unknown date, red spots of skin/redness on the skin on an unknown date, pain in body on an unknown date, Pain in legs on an unknown date, Pain in stomach on an unknown date, Sleeplessness on an unknown date, Sleep problems on an unknown date, Dry skin on an unknown date, Dry hair on an unknown date, Rash on body on an unknown date, Increased sweating on an unknown date, Increased urination on an unknown date and Loss of energy in DEC-2011). The case is upgraded to serious (disabling). The case is now medically confirmed. Date of vaccination for the 2nd Dose (23Jun2010), Route of administration (intramuscular), and batch number for dose 1 (NL 12890, lot# 1334X, expiry: 17-OCT-2011) added.


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