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This is VAERS ID 644275

Case Details

VAERS ID: 644275 (history)  
Age: 13.0  
Gender: Female  
Location: Foreign  
Vaccinated:2009-03-31
Onset:2009-07-01
   Days after vaccination:92
Submitted: 2016-07-15
   Days after onset:2571
Entered: 2016-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / IM

Administered by: Other       Purchased by: Other
Symptoms: Activities of daily living impaired, Blood test, Chest discomfort, Diarrhoea, Disturbance in attention, Dizziness, Dry mouth, Dyspnoea, Fatigue, Grip strength decreased, Memory impairment, Migraine with aura, Mood swings, Nausea, Pain in extremity, Periodontitis, Photophobia, Sleep disorder
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Oropharyngeal infections (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Cardiomyopathy (broad), Corneal disorders (broad), Retinal disorders (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (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
Preexisting Conditions: Asthma exercise induced
Diagnostic Lab Data: Blood samples, assessed at neurologist (private practice)
CDC Split Type: WAES1607DNK006107

Write-up: Information has been received from Sanofi Pasteur MSD (SPM) (DK-1577272925-2016007283) on 13-JUL-2016. NOTE TO AGENCY: Please do not return cases received from the Medicines Agency (MA) unless you received new information regarding this case. Please remember to use the Worldwide unique case identification number for this case: DK-DKMA-WBS-0003982. Also, please note that information should not be deleted from the case (especially not the Patient characteristics). Case received from a physician via HA on 11-Jul-2016, under the reference number DK-SKMA-WBS-0003982. A 13-year-old female adolescent patient received GARDASIL (batch number Lot unknown, Dose 1) via intramuscular route on 21-Jan-2009, GARDASIL (batch number Lot unknown, dose 2) via intramuscular route on 31-Mar-2009, GARDASIL (batch number Lot unknown, dose 3) via intramuscular route on 11-Aug-2009. The patient experienced Migraine aura (JUL-2009), Light sensitive (2009), memory problems (2011), concentration problems (2015), dizziness (2009), shortness of breath mainly while resting (2012), radiating pain in arm (2014), drops things from hands which suddenly loose grip (2014), diarrhoea periodically notable with general symptoms (JUL-2009 and outcome : recovering/resolving). Nausea (2010), tiredness (2009), mood swings (2011), dry mouth (2013), high degree of absence from education and difficulties completing it (unknown date), burning behind the sternum (2010), fragmentary sleep during the last year (2009) and beginning periodontosis (2013). The patient had a medical history of asthma exercise induced. No other medications or vaccines. The patient''s outcome was reported as Not Recovered/Not resolved.


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