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This is VAERS ID 673921

Case Details

VAERS ID: 673921 (history)  
Age: 12.0  
Gender: Female  
Location: Foreign  
Vaccinated:2011-03-02
Onset:2011-09-01
   Days after vaccination:183
Submitted: 2016-09-16
   Days after onset:1842
Entered: 2016-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 2 UN / IM

Administered by: Other       Purchased by: Other
Symptoms: Abdominal pain, Arthralgia, Chest pain, Dizziness, Fatigue, Headache, Muscular weakness, Musculoskeletal pain, Myalgia, Nausea, Neuralgia, Pain in extremity, Photophobia, Sleep disorder, Tilt table test normal, Vision blurred
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Corneal disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? 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: According to tilt table test the patient does not fulfill the diagnostic criteria for POTS.
CDC Split Type: WAES1609DNK007773

Write-up: Information has been received from Sanofi Pasteur MSD (SPMSD) (manufacturer control #) on 15-SEP-2016. Case received from a physician via HA on 12-SEP-2016 under reference no DK-DKMA-WBS-0004438 / DK-DKMA-ADR-23636404. A 13-year-old female adolescent patient received GARDASIL (batch number Not available, Dose 1) via intramuscular route on 03-APR-2010, GARDASIL, (batch number Not available, Dose 2) via intramuscular route on 01-SEP-2010, GARDASIL, (batch number Not available, Dose 3) via intramuscular route on 02-MAR-2011. The patient experienced pain in knee and pain in arms in September 2011; joint pain, muscle pain, headache, neuropathic pain, dizziness, chest pain (non-cardiac), nausea, abdominal cramps/pain, disordered sleep, fatigue, limb weakness, light sensitivity to eyes, difficulty focusing eyes, pain in shoulders, and Increased sick leave in 10th grade on unknown dates. Approximately 6 months after the third vaccine the patient experiences knee pain, pain in the upper arms going down the arms. Then the other reported symptoms followed. Before the vaccinations she was active and performed sports 2 times a week and also did fitness training. But lately she had not been so active due to knee pain. The patient described increased sick leave in the 10th grade. Other vaccines or medicines were not known. The patient''s outcome was reported as not Recovered/not Resolved for Pain in knee. The patient''s outcome was reported as unknown for joint pain, muscle pain, headache, neuropathic pain, dizziness, chest pain (non-cardiac), nausea, abdominal cramps/pain, disordered sleep, fatigue, limb weakness, light sensitivity to eyes, difficulty focusing eyes, pain in shoulders, pain in arms and increased sick leave in 10th grade. The causality between the events and GARDASIL was not provided. The events was considered to be disability.


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