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This is VAERS ID 276838

Case Details

VAERS ID: 276838 (history)  
Form: Version 1.0  
Age: 18.0  
Gender: Female  
Location: Massachusetts  
Vaccinated:2007-01-08
Onset:2007-01-08
   Days after vaccination:0
Submitted: 2007-04-13
   Days after onset:94
Entered: 2007-04-16
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 2 UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
CDC Split Type: WAES0703USA03921

Write-up: Information has been received from a physician, via a company representative, concerning an 18 year old female patient who on 08-JAN-2007 was vaccinated with the first dose, 0.5 of Gardasil, and on approximately 08-MAR-2007 ("two months later") was vaccinated with the second dose, 0.5 ml, of Gardasil. The physician reported that on 08-JAN-2007, soon after receiving the first vaccination, the patient passed out, "she recovered after a short while in the physician office." Following the second vaccination, the physician reported the patient "had no ill effects". Additional information has been requested.


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