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This is VAERS ID 634096

(NOTE: This result is from the 9/14/2017 version of the VAERS database)

Case Details

VAERS ID: 634096 (history)  
Form: Version 1.0  
Age: 13.0  
Sex: Female  
Location: Foreign  
   Days after vaccination:284
Submitted: 2016-04-05
   Days after onset:63
Entered: 2016-04-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Abdominal pain, Blood test normal, Chest pain, Dizziness, Fatigue, Nausea, Neck pain, Orthostatic hypertension, Pain in extremity, Ultrasound scan normal
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (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:
Other Medications: No other medications
Current Illness: Human papillomavirus immunisation
Preexisting Conditions: Appendectomy
Diagnostic Lab Data: Blood test, Repeated several times, all negative; Ultrasound scan, Negative
CDC Split Type: WAES1604GBR000912

Write-up: Information has been received from Sanofi Pasteur MSD (MFR control number GB-1577272925-2016002945) ON 01-APR-2016. This case was received from RA (Ref No. GB-MHRA-EYC 00135594, GB-MHRA-ADR 23363271) on 29-MAR-2016. Initial case received from a consumer/other non-health professional concerns a 13-year-old female adolescent patient received GARDASIL (Lot number J014252, expiry date: 31-JUL-2016) via parenteral route on 24-SEP-2014, GARDASIL (batch number K006781) via parenteral route on 23-APR-2015. The patient experienced "Dizziness and nausea" on 24-NOV-2014, "Various, numerous including abdominal pains so severe, appendix removed", several visits to hospital A&E on 05-MAR-2015, "Pain in legs, arms neck, chest, Orthostatic hypertension, fatigue" on 01-FEB-2016. The reporter stated that they had many trips to doctors over the year, including 3 trips to Accident and Emergency, an unnecessary operation, visits to specialists Respiratory and Cardiologists. The patient had a medical history of Appendectomy. Additional investigations included: Blood Test repeated several times, all negative on an unknown date, Ultrasound Scan negative on an unknown date. The patient''s outcome was reported as Not Recovered/Not Resolved.

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