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This is VAERS ID 648612

Case Details

VAERS ID: 648612 (history)  
Form: Version 1.0  
Age: 12.0  
Gender: Female  
Location: Foreign  
Submitted: 2016-08-19
Entered: 2016-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Abdominal pain, Activities of daily living impaired, Anxiety, Constipation, Diarrhoea, Dizziness, Dyspnoea, Muscular weakness, Nausea, Palpitations, Skin disorder, Sleep disorder, Suicidal ideation, Tilt table test normal, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Suicide/self-injury (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Pseudomembranous colitis (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: HPV immunisation
Preexisting Conditions:
Diagnostic Lab Data: Examinations and/or laboratory tests performed: Yes; Tilt table test (unknown date): Does not fulfill POTS criteria.
CDC Split Type: WAES1608DNK009799

Write-up: Information has been received from Sanofi Pasteur MSD (SPM) (MFR control number DK-1577272925-2016008235) on 18-AUG-2016. Case received from a physician via HA on 15-AUG-2016. A 12-year-old female adolescent patient received GARDASIL, (batch number LOT UNK, Dose 1) via intramuscular route on 01-DEC-2010, GARDASIL, (batch number LOT UNK, Dose 2) via intramuscular route on 16-FEB-2011, GARDASIL, (batch number LOT UNK, Dose 3) via intramuscular route on 04-AUG-2011. The patient experienced anxiety, suicidal/suicidal thoughts, dizziness, palpitation, nausea, abdominal pain, skin disorder, shortness of breath, sleep disorder, weakness of legs, weakness of arms, shaking of hands, obstipation, diarrhea, and a lot of absence from 9th grade and dropped out of 10th grade on an unknown date. Process of the adverse events: patient informs that the first symptoms occurred in between the first and second vaccination - she then debuted with anxiety and suicidal thoughts. Subsequently the rest of the symptoms occurred. Up until the vaccinations the patient played handball 1 time a week. As a consequence of the symptoms the patient has been having a lot of absence from 9th grade and dropped out of 10th grade. She has also been admitted to the child psychiatry unit. Tilt table test shows that she does not fulfill the diagnostic criteria for Postural Orthostatic Tachycardia Syndrome. Other vaccines or medications: unknown. The patient was admitted to hospital on an unspecified date. Additional investigations included tilt table test does not fulfill POTS criteria on an unknown date. The patient''s outcome was reported as not recovered/not resolved.

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