National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 263210

Case Details

VAERS ID: 263210 (history)  
Form: Version 1.0  
Age: 20.0  
Gender: Female  
Location: Pennsylvania  
   Days after vaccination:0
Submitted: 2006-09-14
   Days after onset:30
Entered: 2006-09-19
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0702F / 1 - / IM

Administered by: Other       Purchased by: Other
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Current Illness:
Preexisting Conditions: Penicillin allergy, drug hypersensitivity
Diagnostic Lab Data: NONE
CDC Split Type: WAES0608USA03962

Write-up: Information has been received from a nurse concerning a 20 year old female with a penicillin allergy, drug hypersensitivity to cefaclor (CECLOR) and no other pertinent medical history reported. On 15-AUG-2006, the patient was vaccinated intramuscularly with HPV rLi 6 11 16 18 VLP vaccine (yeast) (Lot#653650/0702F). Concomitant therapy included paroxetine HCL (PAXIL), bupropion HCL (WELLBUTRIN) and famotidine. It was reported that the patient became faint within 5 minutes of vaccination with HPV rLi 6 11 16 18 VLP vaccine (yeast). The patient was given a soda to drink as treatment. There were no laboratory diagnostic studies performed. On 15-AUG-2006, the patient recovered from the event. Additional information has been requested.

New Search

Link To This Search Result:

Copyright © 2018 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166