National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 644172

Case Details

VAERS ID: 644172 (history)  
Form: Version 1.0  
Age: 15.0  
Gender: Female  
Location: Foreign  
Submitted: 2016-07-14
Entered: 2016-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Abdominal pain, Activities of daily living impaired, Arthralgia, Cognitive disorder, Constipation, Diarrhoea, Dizziness, Dry mouth, Dyskinesia, Fatigue, Headache, Myalgia, Nausea, Palpitations, Skin disorder, Syncope, Temperature regulation disorder, Tilt table test normal
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Pseudomembranous colitis (broad), Dyskinesia (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Human papilloma virus, immunisation
Preexisting Conditions:
Diagnostic Lab Data: Tilt-table test showed that the patient does not fulfill the diagnostic criteria for POTS.
CDC Split Type: WAES1607DNK005713

Write-up: Information has been received from SPMSD (manufacturer control# DK-1577272925-2016007285) on 13-JUL-2016. Case received from a physician via HA on 11-Jul-2016 under the reference number DK-DKMA-WBS-0003980. A 16-year-old female adolescent patient received GARDASIL (batch number lot unknown, Dose 1) via intramuscular route on 08-Oct-2008, GARDASIL (batch number Lot unknown, dose 2) via intramuscular route on 06-Jan-2009, GARDASIL (batch number Lot number, Dose 3) via intramuscular route on 14-May-2009. The patient experienced Syncope (2010), Dizziness (2010) and on an unknown date: Headache, palpitation, nausea, abdominal pain, obstipation, diarrhea, skin disorder, fatigue, cognitive disorder, involuntary muscle movement, temperature regulation disorder, joint pain, muscle pain, dry eyes, dry mouth and absence from high school due to sickness on an unknown date. The patient''s outcome was reported as Not Recovered/Not Resolved. Translated narrative: The patient reports that the symptoms started within the first year of all vaccinations. Her first symptoms were syncope and dizziness. The other symptoms have developed subsequently. At the time of vaccination, she had a normal activity level - she went swimming and boxing 3 times per week in total and to the scouts. As a consequence of her many symptoms, she had been absent from high school for sickness. The tilt-table test showed that she does not fulfill diagnostic criteria for Postural Orthostatic Tachycardia Syndrome.

New Search

Link To This Search Result:

Copyright © 2018 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166