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This is VAERS ID 279570

Case Details

VAERS ID: 279570 (history)  
Form: Version 1.0  
Age:   
Gender: Female  
Location: New York  
Vaccinated:2007-04-24
Onset:2007-04-24
   Days after vaccination:0
Submitted: 2007-05-14
   Days after onset:20
Entered: 2007-05-17
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. - / UNK UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / UNK UN / UN
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK UN / UN
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Dizziness, Presyncope
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (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:
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0704USA06035

Write-up: Information has been received from a nurse, via a company representative, concerning a female patient, who on 24-APR-2007 was vaccinated with a dose of Gardasil (Lot #657617/0384U). Concomitant therapy may have included VARIVAX, MMR II and VAQTA. The nurse reported that "after receiving Gardasil, the patient nearly passed out and was lightheaded." The nurse confirmed that the patient had recovered on the same day, 24-APR-2007. The patient sought unspecified medical attention. Additional information has been requested.


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