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This is VAERS ID 631925

Case Details

VAERS ID: 631925 (history)  
Form: Version 1.0  
Age: 14.0  
Gender: Female  
Location: Foreign  
Submitted: 2016-04-15
Entered: 2016-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Arthralgia, Arthropathy, Dizziness, Headache, Immune system disorder, Migraine, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Arthritis (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Immunisation
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1604DNK009322

Write-up: Information has been received from Sanofi Pasteur MSD (manufacturer control number DK-1577272925-2016003711) on 14-APR-2016. Please remember to use the Worldwide unique case identification number for this case: DK-DKMA-ADR 23359847. Also, please note that information should not be deleted from the case (especially not the Patient Characteristics). Case received from a lawyer via health authority on 11-Apr-2016 under reference number DK-DKMA-ADR 23359847. The HAs received the patient''s initial notification to the patient insurance. The patient insurance has not taken a decision in the case. A 14-year-old female adolescent patient received GARDASIL (batch number unknown) in 2010. The patient experienced dizziness in 2012, nausea in 2012, joint pain in 2012, headache in 2012, migraine in 2012, reduced immune system in 2012 and reduced joint function in 2012. The reactions started gradually in 2012 with much reduced immune defence, migraine. The patient contacted the physician several times and was prescribed PRIMPERAN 20 mg for nausea in 2013 and IMIGRAN for migraine in 2013. It culminated in 2015, with hospitalization with dizziness, reduced joint function, nausea and migraine. The patient was discharged with a prescription of EMEPERAL, without improvement. Symptoms of dizziness, joint pain, headache and migraine. The patient has been on sick leave since October 2015 and is still not back. The patient''s outcome was reported as Not Recovered/Not Resolved.

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