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This is VAERS ID 272334

Case Details

VAERS ID: 272334 (history)  
Form: Version 1.0  
Age: 13.0  
Gender: Female  
Location: Unknown  
Vaccinated:2007-01-12
Onset:2007-01-12
   Days after vaccination:0
Submitted: 2007-02-14
   Days after onset:33
Entered: 2007-02-15
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 - / IM

Administered by: Other       Purchased by: Other
Symptoms: Blood pressure, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), 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? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type: WAES0701USA01947

Write-up: Information has been received from a physician concerning a 13 year old female who on 12-JAN-2007 was vaccinated with her first dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) 0.5 ml intramuscularly. The patient fainted when she got outside in the parking lot of the physician''s office (also reported as within 10 minutes). The patient was brought back into the physician''s office and "let rest for a while". The physician checked the patient''s blood pressure (no details provided). The physician noted that the patient is "fine now". Additional information has been requested.


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