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This is VAERS ID 274114

Case Details

VAERS ID: 274114 (history)  
Age: 26.0  
Gender: Female  
Location: New Jersey  
Vaccinated:2007-01-11
Onset:2007-01-11
   Days after vaccination:0
Submitted: 2007-03-14
   Days after onset:61
Entered: 2007-03-16
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / - UN / -

Administered by: Other       Purchased by: Other
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: Syncope
Diagnostic Lab Data: UNK
CDC Split Type: WAES0702USA00437

Write-up: Information has been received from a physician concerning a 26 year old female with a history of syncope when giving blood, who on 11-Jan-2007 was vaccinated with Gardasil (lot #653978/0955F). It was reported that the patient fainted 15 minutes after vaccination. The patient subsequently recovered. No further details were provided. Additional information has been requested.


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