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This is VAERS ID 273915

Case Details

VAERS ID: 273915 (history)  
Form: Version 1.0  
Age: 20.0  
Gender: Female  
Location: Florida  
Vaccinated:2007-03-05
Onset:2007-03-05
   Days after vaccination:0
Submitted: 2007-03-05
   Days after onset:0
Entered: 2007-03-14
   Days after submission:8
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 02634 / 1 LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Hyperhidrosis, Pallor, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (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? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: LOESTRIN 24
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Appeared patient fainted just after vaccine was given, sl diaphoretic pale, recovered quickly after ammonia inhaler was used. Patient rested water was given, left office feeling well.


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