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This is VAERS ID 274199

Case Details

VAERS ID: 274199 (history)  
Form: Version 1.0  
Age:   
Gender: Female  
Location: Pennsylvania  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2007-03-14
Entered: 2007-03-16
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / IJ

Administered by: Other       Purchased by: Other
Symptoms: 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), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (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: passed out
Allergies:
Diagnostic Lab Data: UNK
CDC Split Type: WAES0702USA01353

Write-up: Information has been received from an office manager concerning a female (age not reported) with a history of passing out when receiving shots who on an unspecified date was vaccinated with Gardasil (lot # not reported) 0.5 ml injection. On an unspecified date, the patient passed out after the shot of Gardasil, unknown which dose. Unspecified medical attention was sought. The patient recovered later in the day. Additional information has been requested. Follow-up information was received in which it was reported that no patient had a problem with this vaccine. We have been misinformed. No additional information is expected.


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