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This is VAERS ID 272297

Case Details

VAERS ID: 272297 (history)  
Age: 16.0  
Gender: Female  
Location: Kentucky  
Vaccinated:2006-10-13
Onset:2006-10-13
   Days after vaccination:0
Submitted: 2007-02-14
   Days after onset:124
Entered: 2007-02-15
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 0 LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Dizziness, 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
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: Drug hypersensitivity
Preexisting Conditions: UNK
Diagnostic Lab Data: None
CDC Split Type: WAES0701USA00800

Write-up: Information has been received from a physician concerning a 15 year old female patient who was vaccinated with a first and second dose of Gardasil (yeast). Subsequently the patient fainted 15 minutes after each vaccination. Unspecified medical attention was sought. Additional information has been requested. 07/06/07 This is in follow-up to report(s) previously submitted on 2/14/2007. Initial and follow up information has been received from a physician and a nurse practitioner concerning a 16 year old female with drug hypersensitivity to CECLOR who on 13-OCT-2006, at 15:00 was vaccinated, IM into the left arm with a first dose of GARDASIL (lot# 653978/0955F). The patient fainted 15 minutes after vaccination. On 13-Oct-2006, the patient recovered on her own with mild dizziness, oriented times 3. On 13-DEC-2006, at 15:30 the patient was vaccinated, IM into the right arm with a second dose of GARDASIL (lot# 654389/0961F). She again fainted 10 minutes after vaccination. On 13-DEC-2006, the patient recovered on her own, oriented time 3. There were no laboratory or diagnostic test performed. No further information is available.


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