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This is VAERS ID 267431

Case Details

VAERS ID: 267431 (history)  
Age: 12.0  
Gender: Female  
Location: California  
Vaccinated:2006-10-04
Onset:2006-10-04
   Days after vaccination:0
Submitted: 2006-11-14
   Days after onset:41
Entered: 2006-11-16
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN

Administered by: Other       Purchased by: Other
Symptoms: 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), Cardiomyopathy (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:
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: WAES0610USA08391

Write-up: Information has been received from a registered nurse concerning a 12 year old female with no past medical history who on approximately 10/4/06 was vaccinated, into the arm, with a 0.5ml dose of HPV vaccine. Concomitant therapy included a dose of Hep A vaccine. It was reported that the nurse rubbed the childs arm after the vaccination and the child passed out. The physician thought that it was a vasovagal reaction and revived her with ammonia. On approximately 10/04/06, the pt recovered. Additional information has been requested.


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