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This is VAERS ID 276064

Case Details

VAERS ID: 276064 (history)  
Age: 15.0  
Gender: Female  
Location: Rhode Island  
   Days after vaccination:0
Submitted: 2007-04-11
   Days after onset:20
Entered: 2007-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 0 - / IM

Administered by: Private       Purchased by: Public
Symptoms: Hypotension, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (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? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: Ceclor allergy (rash)
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Passed out in hallway after receiving vaccine. BP 90/30 then elevated to 98/60 took 15 mins to he able to sit up BP normal taken prior to exam 94/60 P 84

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