National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 673776

History of Changes from the VAERS Wayback Machine

First Appeared on 1/14/2017

673776
VAERS Form:
Age:14.0
Gender:Female
Location:Foreign
Vaccinated:2010-03-24
Onset:2010-08-24
Submitted:2016-09-19
Entered:2016-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Arthralgia, Diarrhoea, Dizziness, Dry mouth, Dyspnoea, Dysuria, Fatigue, Hyperhidrosis, Hyperventilation, Lactose intolerance, Memory impairment, Migraine, Nasopharyngitis, Nausea, Palpitations, Pneumonia, Presyncope, Sleep disorder, Syncope, Tension headache, Vision blurred, Activities of daily living impaired, Hot flush, Tilt table 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: Human papilloma virus immunisation
Preexisting Conditions:
Allergies:
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.


Changed on 9/14/2017

673776 Before After
VAERS Form:(blank) 1
Age:14.0
Gender:Female
Location:Foreign
Vaccinated:2010-03-24
Onset:2010-08-24
Submitted:2016-09-19
Entered:2016-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 2 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Arthralgia, Diarrhoea, Dizziness, Dry mouth, Dyspnoea, Dysuria, Fatigue, Hyperhidrosis, Hyperventilation, Lactose intolerance, Memory impairment, Migraine, Nasopharyngitis, Nausea, Palpitations, Pneumonia, Presyncope, Sleep disorder, Syncope, Tension headache, Vision blurred, Activities of daily living impaired, Hot flush, Tilt table 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: Human papilloma virus immunisation
Preexisting Conditions:
Allergies:
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.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=673776&WAYBACKHISTORY=ON


Copyright © 2017 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166