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This is VAERS ID 276881

Case Details

VAERS ID: 276881 (history)  
Form: Version 1.0  
Age: 12.0  
Gender: Female  
Location: Tennessee  
Vaccinated:2007-03-22
Onset:2007-03-22
   Days after vaccination:0
Submitted: 2007-04-13
   Days after onset:22
Entered: 2007-04-16
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Dizziness, Presyncope
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Unknown
CDC Split Type: WAES0703USA04477

Write-up: Information has been received from a physician, via a company representative, concerning a 12 year old female patient, who on 22-MAR-2007 was vaccinated with a dose, 0.5ml, of Gardasil. The physician reported that on 22-MAR-2007, after the vaccination was administered, the patient "experienced dizziness and almost passed out." At the time of the report, it was unknown if the patient had recovered. The patient sought unspecified medical attention. Additional information has been requested.


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