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This is VAERS ID 276650

Case Details

VAERS ID: 276650 (history)  
Form: Version 1.0  
Age:   
Gender: Female  
Location: New Jersey  
Vaccinated:2006-12-12
Onset:2007-03-01
   Days after vaccination:79
Submitted: 2007-04-13
   Days after onset:42
Entered: 2007-04-16
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Unknown       Purchased by: Unknown
Symptoms: Loss of consciousness, Syncope
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), 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unk
Current Illness:
Preexisting Conditions: Unk
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0703USA01569

Write-up: Information has been received from a physician concerning a female who on 12-DEC-2006 was vaccinated with 0.5 ml injection of Gardasil. In early March 2007, the patient passed out. The patient attributed the fainting to the Gardasil dose she received on 12-DEC-2006. Subsequently, the patient recovered. Additional information has been requested.


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