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This is VAERS ID 635490

Case Details

VAERS ID: 635490 (history)  
Age: 14.0  
Gender: Female  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2016-05-11
Entered: 2016-05-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Activities of daily living impaired, Arthralgia, Blood test, Chest pain, Electrocardiogram, Fatigue, Headache, Hypotension, Myalgia, Scan brain, Sensory disturbance, Syncope, Tilt table test, Visual impairment, Vocal cord paralysis
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Human papilloma virus immunisation
Preexisting Conditions:
Diagnostic Lab Data: The patient has gone through blood tests, scanning of the brain, ECG, blood pressure measuring during one day, tilt table test, neurologist, countless doctor visits, examination at two different hospitals.
CDC Split Type: WAES1605DNK004651

Write-up: Information has been received from Sanofi Pasteur MSD (MFR control # 2016004995) as a business agreement on 09-MAY-2016. Case received from a consumer/other non health professional via in Denmark on 04-May-2016 under reference number DK-DKMA-ADR 23455519. A 14-year-old female adolescent patient received GARDASIL, batch number unknown in 2010). The patient experienced Fainting in 2011, Sensory disturbances in 2013, headache in 2011, visual disturbances in 2011, chest pain in JUL-2011, tiredness in 2011, muscle pain in 2012, Paralysis of the right vocal cord in 2014, too low blood pressure in 2013, joint pain in 2012 and has been close to drop out of school due to absence on an unknown date. The patient has not been treated for the adverse events. The patient has not been hospitalized due to the adverse events. Other medication: No. The patient has during the last school year struggled through the school days and has been close to dropping out of school due to sick leave. The patient has gone to bed as soon as she came home from school and have not managed to do things for a longer period of time. The patient has gone through blood tests, scanning of the brain, ECG, blood pressure measuring during one day, tilt table test, neurologist, countless doctor visits, examination at two different hospitals. The names of the physicians at the hospitals has not been reported. MA has requested medical confirmation. The patient recovered from Paralysis of the right vocal cord in 2014. He/She had not recovered from Fainting, Sensory disturbances, headache, joint pain, tiredness, muscle pain, too low blood pressure, visual disturbances. Case outcome is Not recovered/not resolved.


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