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This is VAERS ID 675329

Case Details

VAERS ID: 675329 (history)  
Gender: Female  
Location: Foreign  
   Days after vaccination:0
Submitted: 2016-10-31
   Days after onset:952
Entered: 2016-10-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Bedridden, Epstein-Barr virus infection, Post viral fatigue syndrome
SMQs:, Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Baclofen; azithromycin; lansoprazole
Current Illness: Immunodeficiency common variable, variable immune deficiency; Immunisation
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1610GBR015251

Write-up: Information was received from Sanofi Pasteur (manufacturer control # 2016010903) as part of a business agreement on 28-OCT-2016. This case was received from the RA on 26-OCT-2016 under the reference number GB-MHRA-ADR 23693153. Case received from a consumer/other non health professional. A 15-year-old female adolescent patient received GARDASIL, (batch number unknown) via parenteral route on 24-MAR-2014, GARDAIL, (batch number unknown) via parenteral route on 28-JUL-2014. The patient received concomitant administration of: -Baclofen on an unknown date, -Azithromycin on an unknown date, -Lansoprazole on an unknown date. The patient was firstly bed ridden after second was told this was unusual (onset date 24-MAR-2014). She also experienced Epstein-Barre virus infection and post viral fatigue syndrome on an unknown date. The patient had a medical history of immunodeficiency common variable. The patient''s outcome was reported as Not Recovered/Not Resolved.

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