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This is VAERS ID 275314

Case Details

VAERS ID: 275314 (history)  
Form: Version 1.0  
Age: 13.0  
Gender: Female  
Location: South Carolina  
Vaccinated:2007-03-30
Onset:2007-03-30
   Days after vaccination:0
Submitted: 2007-03-30
   Days after onset:0
Entered: 2007-03-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1208F / 1 LA / IM

Administered by: Other       Purchased by: Public
Symptoms: Blood glucose normal, Blood pressure normal, Dizziness, Heart rate normal, Injection site pain, Oxygen saturation normal, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (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: None
Current Illness: None
Preexisting Conditions: None, NKDA, H/O Reflux
Allergies:
Diagnostic Lab Data: Glucose 96, B/P 104/86, Sat 99%, pulse 75
CDC Split Type:

Write-up: Dizziness, Syncope recovered in few minutes. Patient also complained of severe pain at Vaccine site. Tylenol PO given.


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