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This is VAERS ID 268544

Case Details

VAERS ID: 268544 (history)  
Form: Version 1.0  
Age: 16.0  
Gender: Female  
Location: California  
Vaccinated:2006-12-05
Onset:2006-12-06
   Days after vaccination:1
Submitted: 2006-12-07
   Days after onset:1
Entered: 2006-12-08
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637F / UNK - / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2457AA / UNK - / IM

Administered by: Private       Purchased by: Unknown
Symptoms: Dizziness, Headache, Insomnia, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (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:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CT Scan
CDC Split Type:

Write-up: Several hours after vaccines given pt complained of HA and dizziness, insomnia. Next am s/s worse fainted. taken by paramedics to Hospital ER on 12/6/06.


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