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This is VAERS ID 276658

Case Details

VAERS ID: 276658 (history)  
Form: Version 1.0  
Age:   
Gender: Female  
Location: New York  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2007-04-13
Entered: 2007-04-16
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK - / -

Administered by: Other       Purchased by: Other
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? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0703USA02176

Write-up: Information has been received from a physician concerning a female (age not reported) who on an unspecified date was vaccinated intramuscularly with a dose of Gardasil (yeast). Subsequently, the patient fainted 2 days after receiving the Gardasil vaccine. The patient sought unspecified medical attention. At the time of this report, the outcome was unknown. Additional information has been requested.


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