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This is VAERS ID 272490

Case Details

VAERS ID: 272490 (history)  
Form: Version 1.0  
Age: 16.0  
Gender: Female  
Location: Michigan  
   Days after vaccination:0
Submitted: 2007-02-14
   Days after onset:77
Entered: 2007-02-15
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 653938/0954F / 1 - / IM

Administered by: Private       Purchased by: Other
Symptoms: Blood pressure normal, Body temperature increased, Syncope vasovagal
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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: UNK
Current Illness:
Preexisting Conditions: emotional problems
Diagnostic Lab Data: blood pressure, 11/29/06 112/70; body temp, 11/29/06 100.1f
CDC Split Type: WAES0701USA03460

Write-up: Information has been received from a registered nurse concerning a 16 year old female student with emotional issues (in counseling) who on 29-NOV-2006, at 4:00 PM, was vaccinated IM into the left arm with a first dose of HPV vaccine (yeast) (lot# 653938/0954F). There was no illness at the time of vaccination. It was reported that the vaccination was given while the patient was sitting. A few second after the injection, the patient said "oh", and leaned to the right slowly to a reclined position and remained conscious but stiffened. She was awake. The doctor checked on her and stated that she was having a vagal response. After reclining 5-10 minutes, she said she was ok. Her blood pressure was 112/78 and temperature was 100.1F. The nurse noted that the patient was dressed in multiple layers and a hat and she had no had lunch. The patient was considered recovered on the same day, 29-NOV-2006. Additional information is not expected.

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