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This is VAERS ID 276220

Case Details

VAERS ID: 276220 (history)  
Form: Version 1.0  
Age: 17.0  
Gender: Female  
Location: South Carolina  
   Days after vaccination:0
Submitted: 2007-04-06
   Days after onset:30
Entered: 2007-04-09
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Private       Purchased by: Other
Symptoms: Blood pressure increased, Headache, Loss of consciousness, Neurological examination normal, Syncope, Tooth injury
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), Accidents and injuries (narrow), Hypertension (narrow), Cardiomyopathy (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? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0703USA01156

Write-up: This is in follow-up to report(s) previously submitted on 4/6/2007. Information has been received from a nurse concerning a 17 year old female who on 06-MAR-2007 was vaccinated in the higher anterolateral area of the left thigh with a 0.5 mL second dose of GARDASIL (lot 655617/1447F). At the time of vaccination, the patient was alert and good spirits. The nurse did not notice any bleeding after the injection, but she placed a small bandaid at the injection site. The nurse asked the patient if she was okay, and the patient replied "yes". The patient walked to the check out counter and stated that she had a headache and was rubbing her head. The patient was advised to sit down for 15-20 minutes after the GARDASIL was administered but refused to be seated to passing out. The patient''s blood pressure was slightly elevated while she passed out. The nurse was called to the waiting room after the patient fainted. Neurologic check grossly intact. One tooth was bleeding. The patient was taken to the emergency room and checked in. When the patient''s father arrived, the patient stated that she did not want to stay. The father asked if patient was okay. The nurse informed him that she was okay, but the physician thought the patient should be evaluated at the emergency room. The patient''s father refused treatment. At the time of this report, the outcome was unknown. No additional information is expected.

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