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This is VAERS ID 265955

Case Details

VAERS ID: 265955 (history)  
Age: 13.0  
Gender: Female  
Location: California  
Vaccinated:2006-10-21
Onset:2006-10-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2006-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / -
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / 1 RA / SC

Administered by: Private       Purchased by: Private
Symptoms: Hypoaesthesia, Injection site pain, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Peripheral neuropathy (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Per pt arm where Gardasil was administered felt painful then numb and then pt fainted for a few seconds.


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