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This is VAERS ID 276887

Case Details

VAERS ID: 276887 (history)  
Form: Version 1.0  
Age: 20.0  
Gender: Female  
Location: North Carolina  
   Days after vaccination:0
Submitted: 2007-04-13
   Days after onset:25
Entered: 2007-04-16
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Unknown       Purchased by: Unknown
Symptoms: Blood glucose, Drug administered at inappropriate site, Pallor, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Medication errors (narrow), 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:
Current Illness:
Preexisting Conditions: Papanicolaou smear abnormal
Diagnostic Lab Data: Blood glucose 03/19/2007 110
CDC Split Type: WAES0703USA04616

Write-up: Information has been received from a nurse, via a company representative, concerning a 20 year old female with a history of an abnormal papanicolaou smear, who on 19-MAR-2007 was vaccinated, iM in the buttocks, with the second dose of Gardasil. There was no concomitant medication. The nurse reported that on 19-MAR-2007, a few minutes after the vaccination, the patient "turned pale and fainted for a few seconds." The nurse reported the patient''s blood sugar was 110 (units not specified). Subsequently, the patient recovered on the same day. additional information has been requested.

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