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This is VAERS ID 269820

Case Details

VAERS ID: 269820 (history)  
Form: Version 1.0  
Age: 20.0  
Gender: Female  
Location: South Carolina  
Vaccinated:2006-12-27
Onset:2006-12-28
   Days after vaccination:1
Submitted: 2006-12-28
   Days after onset:0
Entered: 2006-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0961F / 2 RA / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Headache, 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: none
Current Illness: none known
Preexisting Conditions: Allergy Amoxicillin
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient fainted after receiving her second dose of Gardisil Vaccine. Patient c/o headache and pain in back of her head. Returned to office 12/28/06 for exam. Still c/o head pain. To call office prn with followup.


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