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This is VAERS ID 276805

Case Details

VAERS ID: 276805 (history)  
Age: 17.0  
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. - / - UN / IM

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
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: unknown
Diagnostic Lab Data:
CDC Split Type: WAES0703USA03461

Write-up: Information has been received from a physician concerning a 17 year old female who was vaccinated with Gardasil. Subsequently the patient fainted after being administered the vaccine. As of 16-MAR-2007 the patient was recovering. Additional information has been requested.


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