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This is VAERS ID 272313

Case Details

VAERS ID: 272313 (history)  
Form: Version 1.0  
Age: 18.0  
Gender: Female  
Location: Pennsylvania  
   Days after vaccination:0
Submitted: 2007-02-14
   Days after onset:49
Entered: 2007-02-15
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Private       Purchased by: Other
Symptoms: Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (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: Unknown
Current Illness:
Preexisting Conditions: UNK None
Diagnostic Lab Data: UNK None
CDC Split Type: WAES0701USA01335

Write-up: Information has been received from a registered nurse and a physician via a company representative concerning an 18 year old female who on 27-DEC-2006 was vaccinated intramuscularly with one dose of GARDASIL (lot 653978/0955F). On 27-DEC-2006 the patient passed out after getting GARDASIL. The patient sought unspecified medical attention. It was not reported if the patient recovered. Additional information has been requested. This is in follow-up to report (s) previously submitted on 2/14/2007. Initial and follow-up information has been received from a registered nurse via a company representative concerning an 18 year old female student with no reported allergies who on 27-DEC-2006, at 9:30AM. was vaccinated intramuscularly into the left deltoid with a first dose of GARDASIL vaccine (Lot# 653978/0955F). There was no illness at the time of vaccination. Initial information indicated that on 27-DEC-2006 the patient passed out after getting GARDASIL vaccine. Follow-up information from the nurse clarified that the "patient felt faint after the injection but did not faint". The patient told the nurse that she had not eaten so they gave her some "coke" and after she sat for 15 minutes she felt better. The patient was reported as recovered on 27-DEC-2006. Additional information is not expected.

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