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This is VAERS ID 276042

Case Details

VAERS ID: 276042 (history)  
Age: 19.0  
Gender: Female  
Location: Florida  
Vaccinated:2007-04-11
Onset:2007-04-11
   Days after vaccination:0
Submitted: 2007-04-11
   Days after onset:0
Entered: 2007-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0012U / 0 LA / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Anxiety, Computerised tomogram normal, Concussion, Confusional state, Crying, Fall, Head injury, 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), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Depression (excl suicide and self injury) (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE KNOWN
Current Illness: NONE KNOWN
Preexisting Conditions: NONE KNOWN
Diagnostic Lab Data: TRANSFERRED BY AMBULANCE TO HOSP PER MOTHERS REPORT: CLIENT GIVEN IV FLUIDS AND CT SCAN. MOTHER REPORTS CT SCAN NORMAL BUT DID NOT R/O OR CONFIRM CONCUSSION CLIENT RELEASED FROM HOSPITAL AROUND NOON. MOTHER REPORTS ED RECOMMENDED F/U CT SCAN IN 3 MONTHS.
CDC Split Type:

Write-up: APPROXIMATELY 10 MINUTES AFTER VACCINE ADMINISTRATION CLIENT PASSED OUT FALLING AND HITTING HER HEAD. CLIENT AROUSED IN A FEW SECONDS. VITAL SIGNS CHECKED. APPROXIMATELY 20 MINUTES LATER CLIENT REPORTED FEELING ANXIOUS AND CONFUSED, CRYING, AMBULANCE CALLED


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