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This is VAERS ID 277597

Case Details

VAERS ID: 277597 (history)  
Form: Version 1.0  
Age: 11.0  
Gender: Female  
Location: California  
Vaccinated:2007-02-07
Onset:2007-02-07
   Days after vaccination:0
Submitted: 2007-02-07
   Days after onset:0
Entered: 2007-04-30
   Days after submission:81
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0012U / 1 RA / IM

Administered by: Private       Purchased by: Private
Symptoms: Blood test, Computerised tomogram normal, Fatigue, Sinusitis, 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? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness:
Preexisting Conditions: Hx hypoglycemia
Allergies:
Diagnostic Lab Data: CT negative, blood work 24 hr pending. On 2-21-07 doctor treated with Amoxicillin for sinusitis
CDC Split Type:

Write-up: patient fainted in office approx 10 min. after injection. Patient rested a few minutes then went home. About 3:30pm mother reported child was feeling fatigued and was sleeping. Pt had ER visit later. 2-21-07 pt had a followup appt


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