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This is VAERS ID 276946

Case Details

VAERS ID: 276946 (history)  
Age: 16.0  
Gender: Female  
Location: California  
Vaccinated:2007-03-23
Onset:2007-03-23
   Days after vaccination:0
Submitted: 2007-04-13
   Days after onset:21
Entered: 2007-04-16
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / IM

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
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ZYRTEC
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0704USA00199

Write-up: Information has been received from a physician concerning a 14 year old female who on approximately 23-MAR-2007, was vaccinated intramuscularly with a first dose of Gardasil vaccine (yeast). On approximately 23-MAR-2007 the patient fainted. The patient did not seek medical attention. Subsequently, the patient recovered. Additional information has been requested. This is in follow-up to report (s) previously submitted on 4/11/2007. Initial and follow-up information has been received from a physician concerning a 14 year old female who on 12-MAR-2007, at 16:30 was vaccinated intramuscular with a first dose of GARDASIL (lot #654510/0962F). Concomitant therapy included ZYRTEC. On 12-MAR-2007 the patient experienced syncope following vaccination. The patient was given water and trail mix. Te patient also experienced loss of consciousness for a few second. She fell inito a chair in the waiting room and developed a bruise on her left stapula. The patient was observed for 20 minutes. On 12-MAR-2007 the patient recovered. Additional information is not expected.


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