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This is VAERS ID 269820

Case Details

VAERS ID: 269820 (history)  
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 / 1 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
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none known
Preexisting Conditions: Allergy Amoxicillin
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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