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This is VAERS ID 279248

Case Details

VAERS ID: 279248 (history)  
Age:   
Gender: Female  
Location: Missouri  
Vaccinated:2007-01-01
Onset:2007-01-01
   Days after vaccination:0
Submitted: 2007-05-21
   Days after onset:139
Entered: 2007-05-22
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / UN

Administered by: Unknown       Purchased by: Unknown
Symptoms: Concussion, Head injury, Loss of consciousness
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), Accidents and injuries (narrow), 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? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0705USA02247

Write-up: Information has been received from the physician''s office manager concerning a female who in January 2007, was vaccinated with her first dose of Gardasil. In January 2007, after the patient was vaccinated, she walked to the front of the office and "passed out and hit her head on the floor". The patient was taken by ambulance to the hospital where she was admitted with a possible concussion. The patient outcome was not reported. The reporting office manager considered the event to be an other important medical event. No further information is available.


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