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This is VAERS ID 642171

Case Details

VAERS ID: 642171 (history)  
Form: Version 1.0  
Age: 13.0  
Gender: Female  
Location: Foreign  
   Days after vaccination:0
Submitted: 2016-05-26
   Days after onset:475
Entered: 2016-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Abdominal pain upper, Eye pain, Finger deformity, Headache, Heart rate decreased, Heart rate increased, Mood swings, Muscular weakness, Pyrexia, Somnolence
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Depression (excl suicide and self injury) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Immunisation
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1605GBR012468

Write-up: Information has been received from Sanofi Pasteur MSD (MFR control number GB-1577272925-2016005451) on 25-MAY-2016. This case was received from RA (GB-MHRA ADR 23478011) on 20-May-2016. Initial case received from a consumer/other non-health professional concerns a 13-year-old female adolescent patient (Weight: 57.15 kg) received GARDASIL (batch number unknown) via parenteral route on 05-FEB-2015. The patient experienced High temperature, rapid heart rate, sleepy, Low pulse, Mood swings, Eye pain, Muscular weakness, Headache, Abdominal pain upper, Finger deformity on 05-FEB-2015. The patient was admitted to hospital on an unspecified date. The patient''s outcome was reported as Not Recovered/Not Resolved. High temperature, rapid heart rate, low pulse, sleepy, headaches, muscle weakness in legs, fingers bent slightly, eye pain, stomach cramps, mood swings - still has these symptoms. Had reaction same day she received GARDASIL.

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