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This is VAERS ID 644228

History of Changes from the VAERS Wayback Machine

First Appeared on 2/14/2017

644228
VAERS Form:
Age:13.0
Gender:Female
Location:Foreign
Vaccinated:2011-09-26
Onset:0000-00-00
Submitted:2016-07-06
Entered:2016-07-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. G00566 / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Arthralgia, Fatigue, Headache, Malaise, Menstrual disorder, Nausea, Viral infection

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: Insulin
Current Illness: Type 1 diabetes mellitus
Preexisting Conditions: Scoliosis
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES1607IRL001989

Write-up:Information has been received from Sanofi Pasteur MSD (MFR Control Number 2016006998) on 05-JUL-2016, as a part of business agreement. This case was received from RA (Ref no. IE-HPRA-2016-027114) on 01-JUL-2016. Initial case received from a consumer/other non-health professional which concerns a 13-year-old female adolescent patient received GARDASIL (batch number G00566) on 26-MAR-2012, GARDASIL (batch number G00566) on 26-SEP-2011. The patient received concomitant administration of Insulin (Generic) on an unknown date. The patient experienced extreme/chronic fatigue, joint pain, headache, nausea, unexplained recurring viral infections, menstrual problems and feels unwell on an unknown date. The patient had a medical history of: Scoliosis, Type 1 diabetes mellitus. Corrective treatment to date: Complete rest, pain relief and antibiotic for throat, ear and chest infections. No treatment for viral infections. The patient''s outcome was reported as Not Recovered/Not Resolved. The reporter assessed the causal relationship: between Fatigue extreme, Joint pain, Headache, Nausea, Viral infection, Menstrual disorder, Feeling unwell and GARDASIL as Unknown.


Changed on 9/14/2017

644228 Before After
VAERS Form:(blank) 1
Age:13.0
Gender:Female
Location:Foreign
Vaccinated:2011-09-26
Onset:0000-00-00
Submitted:2016-07-06
Entered:2016-07-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. G00566 / 1 2 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Arthralgia, Fatigue, Headache, Malaise, Menstrual disorder, Nausea, Viral infection

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: Insulin
Current Illness: Type 1 diabetes mellitus
Preexisting Conditions: Scoliosis
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES1607IRL001989

Write-up:Information has been received from Sanofi Pasteur MSD (MFR Control Number 2016006998) on 05-JUL-2016, as a part of business agreement. This case was received from RA (Ref no. IE-HPRA-2016-027114) on 01-JUL-2016. Initial case received from a consumer/other non-health professional which concerns a 13-year-old female adolescent patient received GARDASIL (batch number G00566) on 26-MAR-2012, GARDASIL (batch number G00566) on 26-SEP-2011. The patient received concomitant administration of Insulin (Generic) on an unknown date. The patient experienced extreme/chronic fatigue, joint pain, headache, nausea, unexplained recurring viral infections, menstrual problems and feels unwell on an unknown date. The patient had a medical history of: Scoliosis, Type 1 diabetes mellitus. Corrective treatment to date: Complete rest, pain relief and antibiotic for throat, ear and chest infections. No treatment for viral infections. The patient''s outcome was reported as Not Recovered/Not Resolved. The reporter assessed the causal relationship: between Fatigue extreme, Joint pain, Headache, Nausea, Viral infection, Menstrual disorder, Feeling unwell and GARDASIL as Unknown.


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