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This is VAERS ID 278603

Case Details

VAERS ID: 278603 (history)  
Age: 18.0  
Gender: Female  
Location: Florida  
Vaccinated:2007-03-14
Onset:2007-03-14
   Days after vaccination:0
Submitted: 2007-05-08
   Days after onset:55
Entered: 2007-05-15
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0186U / 0 RA / IM

Administered by: Private       Purchased by: Private
Symptoms: Loss of consciousness, Pallor
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: Allergy to Clindamycin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: After injection of Gardasil vaccine 0.5 ml, Pt was sitting talking to her mother. She became pale and passed out for a few minutes. She was revived and walked to exam table. After lying down for 15-20 min.-left the office doing well.


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