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This is VAERS ID 272615

Case Details

VAERS ID: 272615 (history)  
Form: Version 1.0  
Age: 14.0  
Gender: Female  
Location: Massachusetts  
Submitted: 2007-02-14
Entered: 2007-02-15
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Private       Purchased by: Private
Symptoms: Fatigue, Nausea, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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: None
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0702USA00130

Write-up: Information has been received from a physician concerning a 14 year old female patient with no medical history or allergies, who on 03-JAN-2007 and on 06-MAR-2007 was vaccinated with a first and second 0.5 ml dose of GARDASIL, respectively (second dose lot# 653735/0688F given IM). Concomitant therapy given on 03-JAN-2007 included a dose of MENACTRA. There was no illness at the time of vaccination. On approximately 03-JAN-2007, the patient experienced fatigue and subsequently recovered. After the second vaccination on 06-MAR-2007, the patient experienced nausea and extreme fatigue. After one of the vaccination the patient fainted. Unspecified medical attention was sought. Subsequently, the patient recovered. No product quality complaint was involved. Additional information has been requested. Additional information is not expected.

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