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This is VAERS ID 272614

Case Details

VAERS ID: 272614 (history)  
Form: Version 1.0  
Age: 15.0  
Gender: Female  
Location: Massachusetts  
   Days after vaccination:4
Submitted: 2007-02-14
   Days after onset:25
Entered: 2007-02-15
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Fatigue, Hypoaesthesia, Loss of consciousness, Paraesthesia, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (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? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type: WAES0702USA00129

Write-up: Information has been received from a physician concerning a female patient who in "the week of 22-JAN-2007" was vaccinated IM with a 0.5 ml dose of HPV vaccine (yeast). After vaccination, the patient fainted. Unspecified medical attention was sought. Subsequently, the patient recovered. No product quality complaint was involved. Additional information has been requested. 07/06/07 This is in follow-up to report(s) previously submitted 02/14/2007. Information has been received from a physician and a nurse concerning a 15 year old female patient who on 07-MAR-2007, at 2:10, (previously reported as approximately 22-JAN-2007) was vaccinated IM, left deltoid, with a 0.5 ml dose of GARDASIL (lot # 657006/0188U). The patient reportedly had one prior dose of GARDASIL (date unknown). On 11-MAR-2007, late at night/early AM, the patient got up and on the way back to bed, she felt numbness and tingling in her legs then "blacked out for a few minutes". The patient said a friend woke her up. She felt tired all day. Later that afternoon, the patient went to her room, she didn''t feel right. She complained of tingling and numbness in her legs and arms, which lasted 5-10 minutes. Subsequently, the patient recoverd from her symptoms. No product quality complaint was involved. Additional information is not expected.

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