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This is VAERS ID 635485

History of Changes from the VAERS Wayback Machine

First Appeared on 10/14/2016

635485
VAERS Form:
Age:15.0
Gender:Female
Location:Foreign
Vaccinated:2014-03-01
Onset:0000-00-00
Submitted:2016-05-10
Entered:2016-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 2 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Amnesia, Arthralgia, Headache, Hypersomnia, Influenza like illness, Nausea, Pain in extremity, Wheelchair user, Blood test normal, Spinal pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Immunisation
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES1605IRL003059

Write-up:Information has been received from Sanofi Pasteur SPMSD (Manufacturer Control Number # IE-1577272925-2016004990) on 04-MAY-2016. Case received from a consumer/other non health professional on 03-May-2016. A 15-year-old female adolescent patient received GARDASIL (batch number unknown, Dose 1) in Oct-2013, GARDASIL vaccination 4 weeks after 1st dose, GARDASIL (batch number unknown, Dose 3) in Mar-2014. After 10 days of first vaccination the patient had experienced flu like symptoms and she never recovered properly, and suffered from memory loss, nausea, headache, hand pain, spinal pain, joint pain, excessive sleep. The patient is now a wheel chair user. The patient had several hospital visits and blood test are normal. The patient''s outcome was reported as Not Recovered/Not Resolved.


Changed on 9/14/2017

635485 Before After
VAERS Form:(blank) 1
Age:15.0
Gender:Female
Location:Foreign
Vaccinated:2014-03-01
Onset:0000-00-00
Submitted:2016-05-10
Entered:2016-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 2 3 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Amnesia, Arthralgia, Headache, Hypersomnia, Influenza like illness, Nausea, Pain in extremity, Wheelchair user, Blood test normal, Spinal pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Immunisation
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES1605IRL003059

Write-up:Information has been received from Sanofi Pasteur SPMSD (Manufacturer Control Number # IE-1577272925-2016004990) on 04-MAY-2016. Case received from a consumer/other non health professional on 03-May-2016. A 15-year-old female adolescent patient received GARDASIL (batch number unknown, Dose 1) in Oct-2013, GARDASIL vaccination 4 weeks after 1st dose, GARDASIL (batch number unknown, Dose 3) in Mar-2014. After 10 days of first vaccination the patient had experienced flu like symptoms and she never recovered properly, and suffered from memory loss, nausea, headache, hand pain, spinal pain, joint pain, excessive sleep. The patient is now a wheel chair user. The patient had several hospital visits and blood test are normal. The patient''s outcome was reported as Not Recovered/Not Resolved.


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