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This is VAERS ID 274707

Case Details

VAERS ID: 274707 (history)  
Age: 13.0  
Gender: Female  
Location: Unknown  
Vaccinated:2007-02-21
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. - / - - / -

Administered by: Other       Purchased by: Other
Symptoms: Loss of consciousness, Malaise
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
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0702USA04343

Write-up: Information has been received from a registered nurse concerning a 13 year old female who on 21 Feb 2007 was vaccinated with 0.5ml dose of Gardasil. Concomitant therapy included Adacel. Subsequently the patient "felt sick" and passed out. It was reported that the patient was at home when she passed out but it was unknown how long after she received the vaccination. Unspecified medical attention was sought. The patient''s outcome was unknown. Additional information has been requested.


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