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This is VAERS ID 276231

Case Details

VAERS ID: 276231 (history)  
Form: Version 1.0  
Age: 23.0  
Gender: Female  
Location: Ohio  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2007-04-06
Entered: 2007-04-09
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 1 UN / IM

Administered by: Private       Purchased by: Private
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (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? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Diabetes
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0703USA01307

Write-up: Information has been received from an office manager concerning a female patient who was vaccinated with a first dose of Gardasil and fainted after receiving the injection. Unspecified medical attention was sought. The patient recovered. Additional information has been requested. This is in follow-up to report (s) previously submitted on 4/6/2007. In follow up information it was reported that patient had episode of syncope after the injection and it was reaction to needle, not medication (occurred immediatley after withdraw of needle. Used amnoia capsule. On 03-Nov-2006 the patient recovered. Additional information is not expected.


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