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This is VAERS ID 279502

Case Details

VAERS ID: 279502 (history)  
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 / 1 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
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
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.


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