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This is VAERS ID 276804

Case Details

VAERS ID: 276804 (history)  
Age: 16.0  
Gender: Female  
Location: New York  
Vaccinated:2007-03-09
Onset:2007-03-09
   Days after vaccination:0
Submitted: 2007-04-13
   Days after onset:34
Entered: 2007-04-16
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - - / IM

Administered by: Other       Purchased by: Other
Symptoms: Pallor
SMQs:, Hypotonic-hyporesponsive episode (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type: WAES0703USA03455

Write-up: Information has been received from a physician concerning a 16 year old female with no reported medical history who on 09-MAR-2007 was vaccinated with Gardasil intramuscularly. There was no concomitant medication. On 09-MAR-2007 the patient experienced a pale face. Subsequently, the patient recovered from pale face. Additional information has been requested.


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