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This is VAERS ID 279600

Case Details

VAERS ID: 279600 (history)  
Form: Version 1.0  
Age: 16.0  
Gender: Female  
Location: Florida  
Vaccinated:2007-05-22
Onset:2007-05-22
   Days after vaccination:0
Submitted: 2007-05-23
   Days after onset:1
Entered: 2007-05-24
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0954F / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2136AA / 1 RA / IM

Administered by: Private       Purchased by: Private
Symptoms: Dyskinesia, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dyskinesia (narrow), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (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? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Pt has syncope and had jerky movement for a minute. Patients legs were elevated and monitored. Pt recovered after 45 min.


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