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This is VAERS ID 673776

Case Details

VAERS ID: 673776 (history)  
Form: Version 1.0  
Age: 14.0  
Gender: Female  
Location: Foreign  
   Days after vaccination:153
Submitted: 2016-09-19
   Days after onset:2218
Entered: 2016-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Abdominal pain, Activities of daily living impaired, Arthralgia, Diarrhoea, Dizziness, Dry mouth, Dyspnoea, Dysuria, Fatigue, Hot flush, Hyperhidrosis, Hyperventilation, Lactose intolerance, Memory impairment, Migraine, Nasopharyngitis, Nausea, Palpitations, Pneumonia, Presyncope, Sleep disorder, Syncope, Tension headache, Tilt table test normal, Vision blurred
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (narrow), Dehydration (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: Human papilloma virus immunisation
Preexisting Conditions:
Diagnostic Lab Data: Examinations or lab samples: Tilt table test shows that the patient does not fulfill the diagnostic criteria for POTS.
CDC Split Type: WAES1609DNK007725

Write-up: Information has been received from Sanofi Pasteur-MSD (SPM) (Mfr # DK-1577272925-2016009185) on 15-SEP-2016. Case received from a physician via HA on 12-SEP-2016 under reference numbers DK-DKMA-ADR 23635681 / DK-DKMA-WBS-0004426. A 14-year-old female adolescent patient received GARDASIL (batch number Not available, Dosed 1) via intramuscular route on 20-JAN-2010, GARDASIL (batch number, Not available, Dose 2) via intramuscular route on 24-MAR-2010, GARDASIL, (batch number Not available, Dose 3) via intramuscular route on 03-NOV-2010. The patient experienced Abdominal pain, Migraine headache, Tension headaches, Syncope, Near syncope, Dizziness, Palpitation, Nausea, Diarrhea, Lactose tolerance test abnormal, Voiding difficulty, Hyperventilation, Shortness of breath, Fatigue, Dry mouth, sleeping disorder, memory difficulty, frequent colds, Pneumonia, Hot flashes, Sweating abnormal, worsening of joint pain, Difficulty focusing eyes and Tiredness on an unknown date. The patient reported that her first symptom started 4-6 months after 2nd vaccine dose in the form of abdominal pain and diarrhea. Then the other reported symptoms followed. Before vaccinations the patient ran / strength-trained about one and half to 2 hours daily. Still exercises around 4 times per week, but her body feels more tired. Patient has been absent many times from studies due to migraines and fatigue. Patient has started assistant training and also works in the weekends. She always goes home with a headache after work and school and often takes a nap after school or work due to tiredness. Does not have the energy to meet with friends due to tiredness. Other vaccines: No. other medicines: Unknown. The patient''s outcome was reported as Not Recovered/Not Resolved.

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