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This is VAERS ID 643233

History of Changes from the VAERS Wayback Machine

First Appeared on 10/14/2016

643233
VAERS Form:
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: Condition aggravated, Depression, Headache, Influenza like illness, Malaise, Pyrexia, Activities of daily living impaired

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Human papilloma virus immunisation; Depression, concurrent condition of depression
Preexisting Conditions:
Allergies:
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.


Changed on 9/14/2017

643233 Before After
VAERS Form:(blank) 1
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 1 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Condition aggravated, Depression, Headache, Influenza like illness, Malaise, Pyrexia, Activities of daily living impaired

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Human papilloma virus immunisation; Depression, concurrent condition of depression
Preexisting Conditions:
Allergies:
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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