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This is VAERS ID 643233

Case Details

VAERS ID: 643233 (history)  
Age: 14.0  
Gender: Female  
Location: Foreign  
Vaccinated:2015-01-28
Onset:0000-00-00
Submitted: 2016-06-20
Entered: 2016-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. J010357 / 0 UN / IM

Administered by: Other       Purchased by: Other
Symptoms: Activities of daily living impaired, Condition aggravated, Depression, Headache, Influenza like illness, Malaise, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Depression (excl suicide and self injury) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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; Depression, concurrent condition of depression
Preexisting Conditions:
Diagnostic Lab Data: About 6 months after vaccination, she has been diagnosed with depression with complicating eating problems. The patient''s sister also had depression studies and / or laboratory tests: Yes Psychologist and psychiatrist; 2015, Body temperature, fever
CDC Split Type: WAES1606DNK008033

Write-up: Information has been received from Sanofi Pasteur MSD (MFR control number DK-1577292925-2016006287) on 16-JUN-2016. Case received from a HCP (physician) via HA with the reference nrs. DK-DKMA-WBS-0003732 / DK-DKMA-ADR 23518733 on 14-JUN-2016. A 14-year-old female adolescent patient received GARDASIL, (batch/lot number J010357, Dose 1, expiry date: 02-DEC-2015) via intramuscular route on 28-JAN-2015. SIDE EFFECTS: The patient experienced influenza like symptoms, fever, headache, general malaise and 1 year duration of complaints, which contributed to 25% of school absenteeism on an unknown date. HISTORY AROUND side effect: Onset of symptoms after the first vaccination. 1 year duration of complaints, which contributed to 25% of school absenteeism. The patient had a concurrent depression in JUL-2015. About 6 months after vaccination, she had been diagnosed with depression with complicating eating problems. The patient''s sister also had depression. Other vaccine: No. Other medicine: No. The patient''s outcome was reported as recovering/resolving.


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