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This is VAERS ID 276692

Case Details

VAERS ID: 276692 (history)  
Age:   
Gender: Female  
Location: California  
Vaccinated:2007-03-05
Onset:2007-03-05
   Days after vaccination:0
Submitted: 2007-04-13
   Days after onset:38
Entered: 2007-04-16
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN

Administered by: Private       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
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data:
CDC Split Type: WAES0703USA03189

Write-up: Information has been received from a medical assistant concerning a female who on approximately 05-MAR-2007 was vaccinated with the first dose of Gardasil. On approximately 05-MAR-2007 the patient fainted in the waiting room 10 minutes after vaccination. The patient was recovering. The patient will discontinue further series of the vaccine. Additional information has been requested. This is in follow-up to report (s) previously submittedon 4/13/2007. No Further information expected. It was reported that another female fainted after GARDASIL vaccination (WAES 0403USA04745).


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