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This is VAERS ID 648424

Case Details

VAERS ID: 648424 (history)  
Form: Version 1.0  
Age: 15.0  
Gender: Female  
Location: Foreign  
Vaccinated:2009-04-15
Onset:2009-05-01
   Days after vaccination:16
Submitted: 2016-08-18
   Days after onset:2666
Entered: 2016-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 3 UN / IM

Administered by: Other       Purchased by: Other
Symptoms: Abdominal pain, Cognitive disorder, Diarrhoea, Dizziness, Dyskinesia, Dyspnoea, Dysuria, Exercise tolerance decreased, Headache, Infection, Muscular weakness, Nausea, Palpitations, Tilt table test normal
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (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), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Noninfectious diarrhoea (narrow)

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:
Allergies:
Diagnostic Lab Data: Examinations or lab samples: The tilt table test shows that the patient does not fulfill the criteria for Postural Orthostatic Tachycardia Syndrome.
CDC Split Type: WAES1608DNK009252

Write-up: Information has been received from Sanofi Pasteur MSD (SPM) (MFR control number DK-1577272925-2016008229) on 17-AUG-2016. Case received from a physician via health authority on 15-AUG-2016 under reference number DK-DKMA-WBS-0004235. A 15-year-old female adolescent patient received GARDASIL, batch number Not available, Dose 1 via intramuscular route on 08-OCT-2008, GARDASIL, batch number Not available, Dose 2 via intramuscular route on 10-DEC-2008, GARDASIL, batch number Not available, Dose 3 via intramuscular route on 15-APR-2009. The patient experienced recurrent infection, headache, dizziness, palpitation, nausea, abdominal pain, diarrhea, voiding difficulty, shortness of breath, cognitive disorder involuntary muscle movement, weakness of legs/weakness of arms and exercise tolerance decreased on an unknown date. The patient stated that she experienced the first symptom recurrent infection 1 month after her 3rd vaccination. The other symptoms followed. Before her vaccinations, the patient did tennis, fitness, horse-back riding in total 9 hours a week. The tilt table test showed that the patient did not fulfill the criteria Postural Orthostatic Tachycardia Syndrome. Other vaccinations or medications unknown. The patient''s outcome was reported as not recovered/not resolved for headache, dizziness, palpitation, nausea, abdominal pain, diarrhea, voiding difficulty, shortness of breath, cognitive disorder, involuntary muscle movement, and weakness of legs/weakness of arms. The patient''s outcome was reported as unknown for recurrent infection and exercise tolerance decreased.


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