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This is VAERS ID 274113

(NOTE: This result is from the 12/8/2009 version of the VAERS database)

Case Details

VAERS ID: 274113 (history)  
Form: Version .0  
Age: 21.0  
Gender: Female  
Location: New York  
Vaccinated:2007-02-01
Onset:2007-02-01
   Days after vaccination:0
Submitted: 2007-03-14
   Days after onset:40
Entered: 2007-03-16
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 - / IM

Administered by: Other       Purchased by: Other
Symptoms: Blood pressure normal, Dizziness, Fall, Heart rate normal, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (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
Allergies:
Diagnostic Lab Data:
CDC Split Type: WAES0702USA00435

Write-up: Information has been received from a physician concerning a 21 year old female with no known allergies who on 01-FEB-2007 was vaccinated intramuscularly in the right deltoid with Gardasil (lot # not provided). The physician reported that after administering the injection she "turned around literally for a second" and when she turned back to the patient she found her "on the floor, with her rear in the air". The physician stated that she called for her assistant for help and the patient was already conscious, "she was only out for a second". The patient reported to the physician that she felt dizzy and felt like she instantly went to sleep. The physician reported that the patients blood pressure and pulse were normal (actual measurements not provided). The physician reported that the patient was observed in the office, had no additional episodes and considered to have recovered from the event and sent home. The physician stated that she did not feel the event was disabling and would continue the series of vaccination of Gardasil with the patient, but would have her reclined when administering future vaccinations. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20091208&IDNUMBER=274113


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