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This is VAERS ID 276930

Case Details

VAERS ID: 276930 (history)  
Form: Version 1.0  
Age: 18.0  
Gender: Female  
Location: Unknown  
Vaccinated:2007-03-29
Onset:2007-03-29
   Days after vaccination:0
Submitted: 2007-04-13
   Days after onset:15
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: 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: Unk
Current Illness:
Preexisting Conditions: Unk
Allergies:
Diagnostic Lab Data: Unk
CDC Split Type: WAES0703USA05533

Write-up: Information has been received from a Nurse Practitioner (N.P.) concerning an 18 year old female patient who was vaccinated with a dose of Gardasil and fainted after receiving the injection. Unspecified medical attention was sought. On 29-MAR-2007 the patient recovered. Additional information has been requested.


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