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This is VAERS ID 674654

Case Details

VAERS ID: 674654 (history)  
Form: Version 1.0  
Gender: Female  
Location: Foreign  
Submitted: 2016-10-11
Entered: 2016-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. J007883 / 3 UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Arthralgia, Feeling abnormal, Headache, Lyme disease, Migraine, Pharyngeal ulceration, Sinusitis
SMQs:, Agranulocytosis (broad), Systemic lupus erythematosus (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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: Unknown
Preexisting Conditions: Constipation; Asthma; Varicella
Diagnostic Lab Data:
CDC Split Type: WAES1610IRL002927

Write-up: Information has been received from Sanofi Pasteur MSD (SPM) (case report number IE-1577272925-2016009960) on 06-OCT-2016. This report was received from the HPRA on 03-Oct-2016 under reference number IE-HPRA-2016-027889. Case received from a consumer/other health professional on 15-Sep-2016. A 15-year-old female adolescent patient received the first dose of GARDASIL (batch number H013137) via intravenous route on 16-Sep-2013; the second dose of GARDASIL (batch number H019633 was received on 18-Nov-2013 and of GARDASIL batch number J007883 third dose on 24-Mar-2014. The patient experienced throat ulcers, headaches, migraine, sinusitis, brain fog, joint pain and Lyme disease on an unknown date. The patient was admitted to hospital on an unspecified date. The patient had a medical history of constipation, asthma and varicella. The patient''s outcome was reported as Not Recovered/Not Resolved. The reporter assessed the causal relationship: -between throat ulcer and GARDASIL as unknown -between headache and GARDASIL as unknown - between migraine and GARDASIL as unknown -between sinusitis and GARDASIL as unknown - between foggy feeling in head and GARDASIL as unknown -between joint pain and GARDASIL as unknown - between Lyme disease and GARDASIL as unknown.

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