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This is VAERS ID 274325

Case Details

VAERS ID: 274325 (history)  
Form: Version 1.0  
Age: 21.0  
Gender: Female  
Location: California  
Vaccinated:2007-02-09
Onset:2007-02-09
   Days after vaccination:0
Submitted: 2007-03-14
   Days after onset:32
Entered: 2007-03-16
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1208F / 1 - / IM

Administered by: Private       Purchased by: Other
Symptoms: Loss of consciousness, Muscle rigidity, Pallor
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), Parkinson-like events (narrow), 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? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC Split Type: WAES0702USA03827

Write-up: Information has been received from an RN concerning a 21 year old white female student who on 09 Feb 2007 at 11:00 a.m. was vaccinated with her first dose of Gardasil. After giving the injection, the nurse reported that the patient "passed out less then 2 seconds. Patient got extremely almost like a seizure less than 1 second." The patient never lost breathing and came back pale. She was left lying down for 20 minutes, and was discharged well. It was reported that no medical attention was required. No further information is available.


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