National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 643136

Case Details

VAERS ID: 643136 (history)  
Age: 12.0  
Gender: Female  
Location: Foreign  
Vaccinated:2009-05-06
Onset:0000-00-00
Submitted: 2016-06-15
Entered: 2016-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / IM

Administered by: Other       Purchased by: Other
Symptoms: Activities of daily living impaired, Dizziness, Fatigue, Headache, Laboratory test, Neck pain, Neurological examination, Tension headache
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Vestibular disorders (broad), Arthritis (broad)

Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Human papilloma virus immunisation, Schooling compromised for several years. Currently in the process of HF (Higher Preparatory Examination), but with difficulty; Immunisation
Preexisting Conditions:
Diagnostic Lab Data: Have studies and/or laboratory tests been carried out: Yes; Examined at pediatrician, neurologist, headache clinic/tension headaches/.
CDC Split Type: WAES1606DNK006797

Write-up: Information has been received from Sanofi Pasteur MSD (SPM) MFR Control number DK-1577272925-2016006150) on 14-JUN-2016. Case received from a physician via HA on 09-Jun-2016 with reference numbers DK-DKMA-WBS-0003710 / DK-DKMA-ADR 23517077. A 12-year-old female adolescent patient received GARDASIL, (batch/lot number lot not rep, Dose 1) via intramuscular route on 04-Mar-2009, GARDASIL, (batch/lot number Lot Not Rep, Dose 2) on 06-May-2009, GARDASIL, (batch/lot number Lot Not Rep, Dose 3) on 03-Sep-2009. The patient received concomitant administration of PRIORIX 1DF on 04-Mar-2009. The patient experienced dizziness, tiredness, neck pain, schooling compromised for several years. Currently in the process of HF (Higher Preparatory Examination), but with difficulty and tension headache/headache on an unknown date. The patient''s outcome was reported as not recovered/not resolved for all AE. History Around side effect: Vaccination in 2009. Since increasingly tired, dizzy, headaches and neck pain. Is examined by a pediatrician, neurologist and headache clinic/ tension headaches/.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=643136


Copyright © 2017 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166