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This is VAERS ID 670446

Case Details

VAERS ID: 670446 (history)  
Form: Version 1.0  
Gender: Female  
Location: Foreign  
Submitted: 2016-12-07
Entered: 2016-12-08
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Unknown       Purchased by: Unknown
Symptoms: Acne cystic, Amenorrhoea, Appendicitis, Autoimmune neutropenia, Irritable bowel syndrome, Lymphocytic hypophysitis, Scan, Seronegative arthritis, Specialist consultation, X-ray
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Fertility disorders (broad), Arthritis (narrow), Noninfectious diarrhoea (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Immunisation
Preexisting Conditions: Medical History/Concurrent Conditions: Appendectomy
Diagnostic Lab Data:
CDC Split Type: GB0095075131612GBR003301

Write-up: Information has been received from Sanofi Pasteur (MSD) (case report number GB-1577272925-2016012539) as a part of a business agreement on 06-DEC-2016. This case was received from the RA on 01-Dec-2016 under the reference number GB-MHRA-ADR 23328558. Case received from a consumer/other non health professional. A 19-year-old female adult patient received GARDASIL (batch number unknown) via parenteral route in 2008, GARDASIL batch number unknown) via parenteral route in 2009. The patient experienced Acute seronegative arthritis in 2011, Acne cystic in 2011, Acute appendicitis in Nov-2011, Irritable bowel syndrome in 2012, Autoimmune neutropenia in 2012, Autoimmune hypophysitis in 2014 and Amenorrhea secondary in 2013. The patient was admitted to hospital on an unspecified date. The patient had a medical history of Appendectomy. The patient had medication to treat all side effects e.g. Roaccutane, steroids, hydroxychloroquine, sulphasalazine. She now has to have a gluten free, vegan diet. The patient have had consultations with multiple consultants - gynaecologist, haematologist, dermatologist, and rheumatologist, gastroenterologist, admitted to hospital for appendectomy, scopes, scans and X-rays. Additional investigations included: -X-Ray n/a on an unknown date -Scan n/a on an unknown date. The patient recovered from Acute seronegative arthritis in 2013. She had not recovered from Acne cystic, Autoimmune neutropenia, Irritable bowel syndrome. The patient recovered from Autoimmune hypophysitis and Acute appendicitis on unknown date.

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