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This is VAERS ID 262242

Case Details

VAERS ID: 262242 (history)  
Age: 14.0  
Gender: Female  
Location: Washington  
Vaccinated:2006-08-23
Onset:2006-08-23
   Days after vaccination:0
Submitted: 2006-08-28
   Days after onset:5
Entered: 2006-08-29
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0706R / 1 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637F / 0 LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Fall, Fracture, Injury, Loss of consciousness, Syncope vasovagal
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hostility/aggression (broad), Cardiomyopathy (broad), Osteoporosis/osteopenia (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:

Write-up: Vasovagal syncope shortly after receiving hep A and Gardasil vaccine, fell, hit nose on a drawer, loss of consciousness, sent to ER in transport broke nose.


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