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This is VAERS ID 631925

History of Changes from the VAERS Wayback Machine

First Appeared on 10/14/2016

631925
VAERS Form:
Age:14.0
Gender:Female
Location:Foreign
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2016-04-15
Entered:2016-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Arthralgia, Arthropathy, Dizziness, Headache, Immune system disorder, Migraine, Nausea

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Immunisation
Preexisting Conditions:
Allergies:
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.


Changed on 9/14/2017

631925 Before After
VAERS Form:(blank) 1
Age:14.0
Gender:Female
Location:Foreign
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2016-04-15
Entered:2016-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Arthralgia, Arthropathy, Dizziness, Headache, Immune system disorder, Migraine, Nausea

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Immunisation
Preexisting Conditions:
Allergies:
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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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=631925&WAYBACKHISTORY=ON


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