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This is VAERS ID 673409

History of Changes from the VAERS Wayback Machine

First Appeared on 2/14/2017

673409
VAERS Form:
Age:12.0
Gender:Female
Location:Foreign
Vaccinated:2013-01-30
Onset:2013-09-01
Submitted:2016-09-08
Entered:2016-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Dizziness, Headache, Memory impairment, Musculoskeletal pain, Blood test normal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: HPV immunisation; Learning disability; Obsessive-compulsive disorder; Attention deficit/hyperactivity disorder
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Blood samples taken, nothing abnormal.
CDC 'Split Type': WAES1609DNK002769

Write-up:Information has been received from Sanofi Pasteur MSD (SPM) (2016008858) on 06-SEP-2016. Case received from a physician on 01-SEP-2016 under the reference numbers DK-DKMA-WBS-0004380 / DK-DKMA-ADR 23626187. A 13-year-old female adolescent patient received GARDASIL, (batch number Lot unknown, Dose 1) on 10-AUG-2012, GARDASIL, (batch number Lot unknown, Dose 2) on 10-OCT-2012, GARDASIL, (batch number Lot unknown, Dose 3) on 30-JAN-2013. The patient experienced Pain in the musculoskeletal system, memory problems, headache, Attacks of dizziness on an unknown date. The patient had a medical history of: -Obsessive-compulsive disorder; -Attention deficit/hyperactivity disorder. The patient''s outcome was reported as Not Recovered/Not Resolved. No other medications or vaccinations. Translated case summary: "The family insists that there is a connection to the HPV vaccine, although the vaccinations were given greater than 6 months prior to symptom onset. Investigated at orthopaedic surgeon and children''s psychiatrist. Has received the diagnoses OCD, ADHD and Specific Learning Disorder. Total IQ 81."


Changed on 9/14/2017

673409 Before After
VAERS Form:(blank) 1
Age:12.0
Gender:Female
Location:Foreign
Vaccinated:2013-01-30
Onset:2013-09-01
Submitted:2016-09-08
Entered:2016-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Dizziness, Headache, Memory impairment, Musculoskeletal pain, Blood test normal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: HPV immunisation; Learning disability; Obsessive-compulsive disorder; Attention deficit/hyperactivity disorder
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Blood samples taken, nothing abnormal.
CDC 'Split Type': WAES1609DNK002769

Write-up:Information has been received from Sanofi Pasteur MSD (SPM) (2016008858) on 06-SEP-2016. Case received from a physician on 01-SEP-2016 under the reference numbers DK-DKMA-WBS-0004380 / DK-DKMA-ADR 23626187. A 13-year-old female adolescent patient received GARDASIL, (batch number Lot unknown, Dose 1) on 10-AUG-2012, GARDASIL, (batch number Lot unknown, Dose 2) on 10-OCT-2012, GARDASIL, (batch number Lot unknown, Dose 3) on 30-JAN-2013. The patient experienced Pain in the musculoskeletal system, memory problems, headache, Attacks of dizziness on an unknown date. The patient had a medical history of: -Obsessive-compulsive disorder; -Attention deficit/hyperactivity disorder. The patient''s outcome was reported as Not Recovered/Not Resolved. No other medications or vaccinations. Translated case summary: "The family insists that there is a connection to the HPV vaccine, although the vaccinations were given greater than 6 months prior to symptom onset. Investigated at orthopaedic surgeon and children''s psychiatrist. Has received the diagnoses OCD, ADHD and Specific Learning Disorder. Total IQ 81."


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