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This is VAERS ID 675003

Case Details

VAERS ID: 675003 (history)  
Form: Version 1.0  
Age: 13.0  
Gender: Female  
Location: Foreign  
Submitted: 2016-10-12
Entered: 2016-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Abdominal pain upper, Body temperature fluctuation, Colonoscopy, Computerised tomogram, Constipation, Dizziness, Dysmenorrhoea, Endoscopy, Heart rate increased, Nausea, Nuclear magnetic resonance imaging, Pain, Panic attack, Postural orthostatic tachycardia syndrome, Scan, Tachycardia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Codeine phosphate
Current Illness: Immunisation
Preexisting Conditions:
Diagnostic Lab Data: Body temperature (unspecified date): fluctuation; Heart rate (unspecified date): increased
CDC Split Type: WAES1610GBR004060

Write-up: Information has been received from Sanofi Pasteur MSD (manufacturer control # 2016010086) on 11-OCT-2016, as a part of business agreement. This report was received from consumer/other non health professional via the RA on 06-Oct-2016 under reference number GB-MHRA-ADR 23667325. A 13-year-old female adolescent patient who received GARDASIL (batch number unknown) via parenteral route on 25-JAN-2016. The patient received concomitant administration of Codeine Phosphate on an unknown date. The patient experienced severe stomach pains, aches, nausea, POTS, dizziness, tachycardia, panic attacks, menstrual pains, constipation, temperature fluctuations on an unknown date. The patient was admitted several times to hospital on an unspecified date. Additional investigations included body temperature (fluctuation), computerized tomogram, endoscopy, nuclear magnetic resonance imaging, colonoscopy, heart rate (increased) and scan on an unknown date (result not provided). The patient''s outcome was reported as Not Recovered/Not Resolved.

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