National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 276869

Case Details

VAERS ID: 276869 (history)  
Form: Version 1.0  
Age: 19.0  
Gender: Female  
Location: Ohio  
Vaccinated:2007-03-20
Onset:2007-03-20
   Days after vaccination:0
Submitted: 2007-04-13
   Days after onset:24
Entered: 2007-04-16
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0244U / 1 - / IM

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
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: LOESTRIN
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC Split Type: WAES0703USA04224

Write-up: Information has been received from a registered nurse concerning a 19 year old female who on 20 Mar-2007 was vaccinated with a 0.5 ml dose of Gardasil vaccine (yeast) (lot # 656051/0244U). Concomitant medication included ethinyl estradiol (+) norethindrone acetate "1/20 BCP''s." On 20-MAR-2007 the patient fainted after receiving a shot of the vaccine. The patient laid down, smelling salt used and was given juice and a granola bar. The patient had not eaten since the night before. Subsequently, the patient recovered in less than 5 minutes. No product quality complaint was involved. Additional information has been requested.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=276869


Copyright © 2017 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166