National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 279502

Case Details

VAERS ID: 279502 (history)  
Form: Version 1.0  
Age: 17.0  
Gender: Female  
Location: Massachusetts  
Vaccinated:2007-04-19
Onset:2007-04-19
   Days after vaccination:0
Submitted: 2007-05-14
   Days after onset:25
Entered: 2007-05-17
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0013U / 2 LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Presyncope, Similar reaction on previous exposure to drug
SMQs:, Anticholinergic syndrome (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: None
CDC Split Type: WAES0704USA04285

Write-up: Information has been received from a nurse practitioner concerning a female (age unknown) who on 19-APR-2007 was vaccinated with a first dose of Gardasil. After receiving the Gardasil, the patient "almost fainted". The patient sought unspecified medical attention. No laboratory diagnostic studies were performed. On 19-APR-2007, the patient recovered. No product quality complaint was involved. Additional information has been requested. 07/06/07 This is in follow-up to report(s) previously submitted on 5/14/2007. Information has been received from a nurse practitioner concerning a 17 year old female who on 19-APR-2007 at 10:59 was vaccinated intramuscularly into the left arm with a second dose of GARDASIL (Lot #654741/0013U). After receiving the GARDASIL (also reported as 10:30), the patient "almost fainted" and had a vasovagal response. There was no loss of consciousness. The patient sought unspecified medical attention. No laboratory diagnostic studies were performed. On 19-APR-2007, the patient recovered as the symptoms only lasted a few minutes. No product quality complaint was involved. No additional information is expected.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=279502


Copyright © 2018 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166