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This is VAERS ID 270411

Case Details

VAERS ID: 270411 (history)  
Form: Version 1.0  
Age: 52.0  
Gender: Female  
Location: Missouri  
Vaccinated:2007-01-11
Onset:2007-01-11
   Days after vaccination:0
Submitted: 2007-01-11
   Days after onset:0
Entered: 2007-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 142AA / 1 RA / -

Administered by: Private       Purchased by: Private
Symptoms: Nausea, Pallor, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (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:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient felt faint, nauseated, pale. Patient laid down symptoms resolved after 10 minutes.


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