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This is VAERS ID 270093

Case Details

VAERS ID: 270093 (history)  
Form: Version 1.0  
Age: 18.0  
Gender: Female  
Location: New York  
Vaccinated:2006-12-26
Onset:0000-00-00
Submitted: 2006-12-26
Entered: 2007-01-05
   Days after submission:10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1208F / 1 LA / SC

Administered by: Private       Purchased by: Private
Symptoms: Dizziness, Feeling hot, 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? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: 10 minutes after receiving Gardasil #1-patient became dizzy,hot, blacked out. Patient recovered completely after 20 minutes.


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