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This is VAERS ID 632129

Case Details

VAERS ID: 632129 (history)  
Form: Version 1.0  
Age: 12.0  
Gender: Female  
Location: Foreign  
Vaccinated:2012-09-26
Onset:2013-06-01
   Days after vaccination:248
Submitted: 2016-03-21
   Days after onset:1024
Entered: 2016-03-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 3 UN / IM

Administered by: Other       Purchased by: Other
Symptoms: Abdominal pain, Depression, Dizziness, Laboratory test normal, Panic disorder
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (narrow), Vestibular disorders (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: Regular tests, all essentially unremarkable.
CDC Split Type: WAES1603DNK008589

Write-up: Information has been received from Sanofi Pasteur MSD (MFR number# DK-1577272925-2016002410) on 17-MAR-2016. Case received from a physician via HA on 15-MAR-2016. A 12-year-old female adolescent patient received GARDASIL, (batch number unknown) via intramuscular route on 26-SEP-2012. The patient experienced abdominal pain in JUN-2013, dizziness in JUN-2013, depression on an unknown date, panic attacks on an unknown date and discouragement and trouble manageable challenges on an unknown date. There are with discouragement and difficulty manageable challenges, which currently was the patient''s main limitation. Was investigated in child/adolescent psychiatry, where assessment of depression and panic disorder were found. Other vaccines: No. Other medicines: No. The patient''s outcome was reported as not recovered/not resolved.


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