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This is VAERS ID 267926

Case Details

VAERS ID: 267926 (history)  
Age: 17.0  
Gender: Female  
Location: California  
Vaccinated:2006-11-22
Onset:2006-11-22
   Days after vaccination:0
Submitted: 2006-11-22
   Days after onset:0
Entered: 2006-11-29
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0702F / 0 LA / IM

Administered by: Private       Purchased by: Private
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
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: Patient fainted after administration of vaccine.


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