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This is VAERS ID 276815

Case Details

VAERS ID: 276815 (history)  
Age: 13.0  
Gender: Female  
Location: Unknown  
Vaccinated:2007-03-17
Onset:2007-03-17
   Days after vaccination:0
Submitted: 2007-04-13
   Days after onset:27
Entered: 2007-04-16
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / - UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Syncope, Underdose
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Medication errors (broad), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0703USA03681

Write-up: Information has been received from a nurse concerning a 13 year old female patient who on 17-MAR-2007 was vaccinated with a dose of Gardasil, lot #655619/1427F. The nurse reported that she noticed that the syringe was leaking, and she couldn''t quantify how much vaccine was received. She added that several minutes after the injection, the patient felt a bit faint, but recovered with no specific intervention. No further information is available.


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