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This is VAERS ID 272317

Case Details

VAERS ID: 272317 (history)  
Age: 20.0  
Gender: Female  
Location: Pennsylvania  
Vaccinated:2006-12-22
Onset:2006-12-22
   Days after vaccination:0
Submitted: 2007-02-14
   Days after onset:54
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: 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
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: NONE
CDC Split Type: WAES0701USA01401

Write-up: Information has been received from a registered nurse concerning a 20 year old female who on 22-DEC-2006 was vaccinated with Gardasil (yeast) (lot number 653978/0955F). On 22-DEC-2006 the patient passed out after vaccination. 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 concerning a 20 year old female student with no reported allergies who, at 10:00AM on 22-DEC-2006, was vaccinated into the left deltoid with a first dose of GARDASIL (Lot# 653978/0955F). There was no illness at the time of vaccination. On 22-DEC-2006, after the vaccination, the patient felt faint and passed out for a short time. The nurse reported that the patient was watched closely and felt fine after a while and then left the office, recovered the same day, 22-DEC-2006. Additional information is not expected.


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