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This is VAERS ID 644235

Case Details

VAERS ID: 644235 (history)  
Form: Version 1.0  
Age: 14.0  
Gender: Female  
Location: Foreign  
Vaccinated:2013-03-21
Onset:2013-06-01
   Days after vaccination:72
Submitted: 2016-07-05
   Days after onset:1130
Entered: 2016-07-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. H013135 / 3 UN / UN
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Dizziness, Epistaxis, Fatigue, Feeling abnormal, Headache, Hyperacusis, Mobility decreased, Muscular weakness, Nausea, Quality of life decreased, Vision blurred, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hearing impairment (narrow), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (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: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: WAES1607IRL000466

Write-up: Information has been received from Sanofi Pasteur MSD (reference # IE-1577272925-2016006866) on 01-JUL-2016. This case was received from RA (Ref no. IE-HPRA-2016-027090) on 29-Jun-2016. Initial case received from a consumer/other non-health professional which concerns a 14-year-old female adolescent patient received GARDASIL (batch number G019345) on 20-Sep-2012, GARDASIL (batch number H008259) on 15-Nov-2012, GARDASIL (batch number H013135) on 21-Mar-2013. The patient received concomitant administration of BOOSTRIX on 21-Mar-2013. Medical history/concurrent conditions: None. The patient experienced Headaches, Dizziness, Loss of power of limbs, Nosebleeds, Blurred vision, Fatigue, Noise sensitivity, Brain fog, Vomiting and Nausea on 01-Jun-2013 72 days Post Administration. The reporter added that her daughter has lost her quality of life. She has been poorly since 2013 and to this day is no better. She was a healthy, outgoing girl involved in sports and socializing with her friends. Now most days she can hardly get out of bed. The patient''s outcome was reported as Not Recovered/Not Resolved. The reporter assessed the causal relationship between Headache, Dizziness, Weakness of limbs, Nosebleeds, Blurred vision, Fatigue, Sound sensitivity increased, Foggy feeling in head, Vomiting, Nausea and GARDASIL as Unknown.


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