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This is VAERS ID 673777

Case Details

VAERS ID: 673777 (history)  
Form: Version 1.0  
Age: 12.0  
Gender: Female  
Location: Foreign  
   Days after vaccination:0
Submitted: 2016-09-19
   Days after onset:2848
Entered: 2016-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Abdominal pain, Activities of daily living impaired, Anxiety, Arthralgia, Cognitive disorder, Constipation, Cystitis, Depression, Diarrhoea, Dizziness, Dry eye, Dry mouth, Dyspnoea, Dysuria, Headache, Influenza, Migraine with aura, Muscular weakness, Myalgia, Nausea, Oropharyngeal pain, Palpitations, Sleep disorder, Temperature regulation disorder, Tilt table test normal
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (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), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Corneal disorders (broad), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (narrow), Vestibular disorders (broad), Conjunctival disorders (narrow), Lacrimal disorders (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Infective pneumonia (broad), 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: HPV immunisation
Preexisting Conditions:
Diagnostic Lab Data: Tilt-table test shows that she doesn''t fulfill the diagnostic criteria for postural orthostatic tachycardia syndrome.
CDC Split Type: WAES1609DNK007430

Write-up: Information was received from Sanofi Pasteur MSD (MCN #: DK-1577272925-2016009199) on 15-SEP-2016. Case received from a physician via HA on 12-Sep-2016 under the reference number DK-DKMA-WBS-0004427. A 12-year-old female adolescent patient received GARDASIL, (batch number Lot unknown, Dose 1) via intramuscular route in Dec-2008, GARDASIL, (batch number Lot unknown, Dose 2) via intramuscular route on 07-Jan-2009, GARDASIL, (batch number Lot unknown, Dose 3) via intramuscular route on 06-May-2009. The patient experienced Headache, Dizziness, Palpitation, Nausea, Abdominal pain, Voiding difficulty, Shortness of breath, Sleep disorder, Cognitive disorders, weakness of legs, frequent flu, frequent sore throat, frequent cystitis, Temperature regulation disorder, Muscle pain, Joint pain, Dry eyes, Dry mouth, Diarrhea, Obstipation, Migraine with aura, Frequent absence from school (due to illness), depression and Anxiety on an unknown date. Case description: The patient states that her first symptoms started after the first vaccination, with headache. She has later been diagnosed with migraine with aura, something she suffers from daily. The other symptoms have developed subsequently. At the time of vaccination, the patient played badminton twice weekly and was boxing twice weekly. As a consequence of her symptoms, the patient has also developed depression and anxiety. Her absence from school was commented upon. She has also nearly been expelled from high school due to 2 months sick leave, after which she has only been able to attend 4 hours per day for a couple of months. Other vaccines or medications: unknown. The patient''s outcome was reported as Not Recovered/Not Resolved.

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