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This is VAERS ID 269922

Case Details

VAERS ID: 269922 (history)  
Age: 21.0  
Gender: Female  
Location: Virginia  
Vaccinated:2006-11-13
Onset:2006-11-13
   Days after vaccination:0
Submitted: 2006-12-29
   Days after onset:46
Entered: 2007-01-02
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637F / - UN / IM

Administered by: Other       Purchased by: Other
Symptoms: Dizziness, Fracture, Injury, Nausea, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Osteoporosis/osteopenia (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec, Yasmin
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES0612USA02987

Write-up: Information has been received from a 21 year old female with no pertinent medical history or drug reactions/allergies, who on 13 Nov 2006 was vaccinated intramuscularly with HPV Vaccine. Concomitant therapy included Zyrtec and Yasmin. On 13 Nov 2006, following vaccination, the patient felt nauseous and dizzy. As she went out of the room to check out, the patient fainted and broke her nose and got a cut under eye. The patient reported that she was on the floor for seven to eight minutes before she woke up. The patient reported that she had to get her nose fixed and received some stitches afterward. At the time of this report, the patient was recovering. Upon internal review, the facial bones fracture which required surgery was felt to be an other important medical event (OMIC). Additional information has been requested.


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