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This is VAERS ID 279211

Case Details

VAERS ID: 279211 (history)  
Age: 16.0  
Gender: Female  
Location: Unknown  
Vaccinated:2007-03-23
Onset:2007-03-23
   Days after vaccination:0
Submitted: 2007-05-14
   Days after onset:52
Entered: 2007-05-17
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Fall, Injection site pain, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unk
Current Illness:
Preexisting Conditions: Unk
Diagnostic Lab Data: Unk
CDC Split Type: WAES0704USA02541

Write-up: Information has been received from the mother concerning her 16 year old daughter who on 23-MAR-2007 was vaccinated with Gardasil. The patient fainted a few minutes after being vaccinated. No injury was noted due to the fall. The patient also stated that the vaccination was very painful. Medical attention was sought. At the time of reporting, the patient had recovered. No further information was available at the time of reporting. Additional information has been requested.


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