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This is VAERS ID 279235

Case Details

VAERS ID: 279235 (history)  
Age: 16.0  
Gender: Female  
Location: New York  
   Days after vaccination:0
Submitted: 2007-05-14
   Days after onset:43
Entered: 2007-05-17
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Dizziness, Loss of consciousness, Syncope
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), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: ALEVE
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0704USA03464

Write-up: Information has been received from a nurse practitioner, via a company representative, concerning a 16 year old female patient, who in April 2007, was vaccinated with a dose of Gardasil. Concomitant therapy included Menactra and Vaqta. The nurse practitioner stated that the patient "fainted after she received the Gardasil vaccination. " The "patient was given liquids to drink and something to eat, and she was fine." Additional information has been requested. This is in follow-up to report (s) previously submitted on 5/14/2007. Initial follow up information has been received. There was no illness at the time of vaccination. The nurse practioner stated that as the patient walked from the exam room at 8:35, she felt lightheaded, passed out and fell and hit her right occipital area. The NP stated that the patient had not eaten that morning, and was given juice and a banana. The patient left the office after about 10 minutes, and recovered on the same day, 10-Mar-2007. No further information is expected.

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