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This is VAERS ID 279050

Case Details

VAERS ID: 279050 (history)  
Form: Version 1.0  
Age:   
Gender: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2007-05-31
Entered: 2007-05-17
   Days after submission:14
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? No
Office Visit? No
ER Visit? No
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: WAES0704USA00572

Write-up: Information has been received from a company representative, reporting on a literature article (article name and author not specified) concerning patients who were vaccinated with a dose or doses of GARDASIL (date unspecified). According to the article, there were 4 cases of fainting after receiving GARDASIL. Additional information has been requested. This is in follow-up to report (s) previously submitted on 5/14/2007. Follow up information confirmed that only one patient was identified with the events (WAES #0610USA04009). Therefore, WAES # 0704USA000572 is being deleted from our files. No further information is expected. This report was previously sent in a monthly submission to PLA V501 on 14-MAR-2007.


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