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This is VAERS ID 673778

Case Details

VAERS ID: 673778 (history)  
Form: Version 1.0  
Age: 13.0  
Gender: Female  
Location: Foreign  
Vaccinated:2009-07-01
Onset:2009-09-01
   Days after vaccination:62
Submitted: 2016-09-18
   Days after onset:2574
Entered: 2016-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 3 UN / IM

Administered by: Other       Purchased by: Other
Symptoms: Activities of daily living impaired, Arthralgia, Constipation, Diarrhoea, Dizziness, Dyskinesia, Dyspnoea, Dysuria, Fatigue, Food allergy, Gluten sensitivity, Headache, Immunodeficiency, Increased tendency to bruise, Infection, Influenza, Lactose intolerance, Nausea, Palpitations, Photophobia, Skin disorder, Tilt table test, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Pseudomembranous colitis (broad), Dyskinesia (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Cardiomyopathy (broad), Corneal disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), Infective pneumonia (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: No other medications
Current Illness: HPV immunisation
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Tilt-table test shows that she doesn''t fulfill the diagnostic criteria for Postural Orthostatic Tachycardia Syndrome
CDC Split Type: WAES1609DNK007777

Write-up: Information has been received from Sanofi Pasteur MSD (manufacturer control # DK-1577272925-2016009198) on 15-SEP-2016. Case received from a physician via HA on 12-Sep-2016 under the reference number DK-DKMA-WBS-0004425. A 14-year-old female adolescent patient received GARDASIL, (batch number Lot unknown, Dose 1) via intramuscular route on 29-Oct-2008, GARDASIL, (batch number Lot unknown, Dose 2) via intramuscular route on 23-Jan-2009, GARDASIL, (batch number Lot unknown, Dose 3) via intramuscular route on 01-Jul-2009. The patient experienced recurrence flu, headache, dizziness, palpitation, nausea, voiding difficulty, frequent bruises, skin disorder, shortness of breath, fatigue, involuntary muscle movement, immunocompromised, light sensitivity, lactose sensitivity, gluten sensitivity, pain in knee, diarrhea, obstipation, spontaneous vomiting, recurrent infection and infection on an unknown date. The patient was admitted to hospital on an unspecified date. The patient''s outcome was reported as Not Recovered/Not Resolved. Case description: The patient states that the first symptoms developed 2-3 months after the 3rd vaccination. She developed recurring flu and infection. The other symptoms have developed subsequently. The patient received her vaccinations in 7th grade and trained gymnastics once weekly and football twice weekly with games on some weekends. As a consequence of her symptoms, the patient doesn''t study. In general, she needs to prioritise her energy due to her symptoms. She turned very light sensitive, which makes it very difficult to e.g. to sports. She developed food allergy, which affects her socially. No other vaccines, other medications are not known.


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