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This is VAERS ID 263244

Case Details

VAERS ID: 263244 (history)  
Form: Version 1.0  
Age: 20.0  
Gender: Female  
Location: California  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2006-09-14
Entered: 2006-09-19
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / -

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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0609USA00266

Write-up: Information has been received from a nurse in a physician''s office concerning a female patient "in her 20''s" who on an unspecified date was vaccinated with HPV rLi 6 11 16 18 VLP vaccine (yeast). It was reported that the patient "fainted" after being given HPV rLi 6 11 16 18 VLP vaccine (yeast) (date unknown). At the time of this report, the outcome of the event was unknown. Additional information has been requested.


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