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This is VAERS ID 272350

Case Details

VAERS ID: 272350 (history)  
Form: Version 1.0  
Age: 24.0  
Gender: Female  
Location: Virginia  
   Days after vaccination:0
Submitted: 2007-02-14
   Days after onset:105
Entered: 2007-02-15
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Injection site irritation, Loss of consciousness, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (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), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Hormonal contraceptives, influenza virus vaccine
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type: WAES0701USA02369

Write-up: Information has been received from a 24 year old female with an unremarkable medical history and no known allergies or adverse drug reactions reported. In November 2006, the patient was vaccinated intramuscularly in the left arm with the first 0.5 ml dose of Gardasil. concomitant therapy included influenza virus vaccine (unspecified) and hormonal contraceptives (unspecified). In November 2006, right after she received her first injection of Gardasil, the patient vomited and the passed out. The patient developed burning at injection site. The patient sought unspecified medical attention. It was reported that the patient was alright after about 20 minutes after the injection. The patient plans to receive her second shot on 17-JAN-2007. In November 2006, the same day that the first dose of the vaccine was administered, the patient had recovered from the events. Additional information has been requested.

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