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This is VAERS ID 693614

Case Details

VAERS ID: 693614 (history)  
Form: Version 1.0  
Age: 12.0  
Gender: Female  
Location: Foreign  
   Days after vaccination:591
Submitted: 2016-07-03
   Days after onset:913
Entered: 2016-07-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. G009615 / 3 UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Cardiovascular examination, Disturbance in attention, Dizziness, Dry eye, Dry mouth, Fatigue, Food aversion, Headache, Laboratory test, Loss of personal independence in daily activities, Memory impairment, Migraine, Nausea, Pallor, Photophobia, Pyrexia, Scan brain, Specialist consultation
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Conjunctival disorders (narrow), Lacrimal disorders (narrow), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (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? No
Previous Vaccinations:
Other Medications: PRIORIX
Current Illness: Immunisation; Human papilloma virus immunisation
Preexisting Conditions:
Diagnostic Lab Data: Many examinations and test have been made over time. Head is scanned, ear specialist, eye specialist and others have examined for dizziness and eye disease. Heart has been examined at cardiology department. All with no results. In May 2014, the patient''s body temperature slightly increased. 05/2014, Body temperature, slight fever (37.6), increased.
CDC Split Type: WAES1607DNK000018

Write-up: Information has been received from Sanofi Pasteur MSD (SPM) (MFR#: DK-1577272925-2016006714) on 30-JUN-2016. Case received from a consumer/other non-health professional via HA on 27-Jun-2016 under the case number DK-DKMA-WBS-0003866. A 12-year-old female adolescent patient received GARDASIL, (batch number NN20940, Dose 1) on 18-Jul-2011, GARDASIL, (batch number G009615, Dose 2) on an unknown date, GARDASIL, (batch number G009615, Dose 3) on 20-May-2012. The patient received concomitant administration of PRIORIX 1DF on 18-Jul-2011. The patient experienced Dizziness, Nausea, Migraine attacks, Pale, Dry eyes, Dry mouth, Slight fever (37.6), Concentration problems, Tiredness, Memory problems / problems with short-term memory, Food aversion, Constant headache, Light sensitivity and School attendance impossible in 8th and 9th grade, she wasn''t admitted to high school due to sick absence on an unknown date. The patient recovered from Slight fever (37.6) in APR-2015. She had not recovered from Dizziness, Nausea, Migraine attacks, Pale, School attendance impossible in 8th and 9th grade, she wasn''t admitted to high school due to sick absence, Tiredness, Memory problems / problems with short-term memory, Food aversion, Constant headache, Concentration problems. Dry eyes, dry mouth and photophobia: recovering. The patient had not been treated for the events. Notes: The adverse events have made going to school impossible in 8th and 9th grades. Which has consequently lead to that she has not been admitted to high school due to absence. She has therefore attended 10th grade at a continuation school. She has concentration problems and problems with short term memory, and the parents are therefore worried that she may not be able to finish high school.

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