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This is VAERS ID 660965

Case Details

VAERS ID: 660965 (history)  
Form: Version 1.0  
Age:   
Gender: Female  
Location: Unknown  
Vaccinated:2014-03-01
Onset:2014-04-01
   Days after vaccination:31
Submitted: 2016-10-21
   Days after onset:934
Entered: 2016-10-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Abasia, Activities of daily living impaired, Coeliac disease
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Guillain-Barre syndrome (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: WAES1610USA010938

Write-up: This spontaneous report was received from a Nurse via a company representative referring to a female patient of unknown age. The patient''s pertinent medical history, concurrent conditions and concomitant therapies were not reported. In March 2014, the patient was vaccinated with a dose of GARDASIL (Dose, route, lot # and expiration date were not provided). In April 2014 (reported as a month later), the patient lost her ability to walk and play sports and was home-bound and could not go to school. In November 2015, the patient was diagnosed with coeliac disease. It was stated that the patient was placed on a "special diet" and that 2 weeks after she started the diet she was fine and back to normal. At the time of reporting, the outcome of abasia was unknown. The causality assessment between the events and GARDASIL was not provided. Upon internal review, coeliac disease was determined to be medically significant. Additionally, abasia was determined to be medically significant and disabling. Additional information has been requested.


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