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This is VAERS ID 274068

Case Details

VAERS ID: 274068 (history)  
Age: 18.0  
Gender: Female  
Location: Unknown  
Vaccinated:2007-02-28
Onset:2007-02-28
   Days after vaccination:0
Submitted: 2007-03-15
   Days after onset:14
Entered: 2007-03-16
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0688F / 0 UN / -
MEN: MENINGOCOCCAL (MENOMUNE) / SANOFI PASTEUR - / - UN / -

Administered by: Other       Purchased by: Other
Symptoms: Convulsion, Fall, Head injury, Orthostatic intolerance, Syncope, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type: WAES0703USA00641

Write-up: Information has been received from a pharmacist concerning an 18 year old female patient who on 28-FEB-2007 was vaccinated with a first dose of Gardasil, Lot #653735/0688F. Concomitant therapy included Menomune. The patient fainted 10 minutes after injection Gardasil. The patient fell and hit her head when she fainted. The patient then had a seizure for 30 seconds after she fell after fainting. The patient was slow to wake and was Orthostatic (time line was unspecified). The patient also vomited twice (no time line). The patient recovered later in the day. The reporter considered the events to be disabling. Upon internal review, seizure was considered to be an other important medical event. Additional information has been requested.


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