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This is VAERS ID 280281

Case Details

VAERS ID: 280281 (history)  
Form: Version 1.0  
Age: 13.0  
Gender: Female  
Location: Massachusetts  
Vaccinated:2007-05-29
Onset:2007-05-29
   Days after vaccination:0
Submitted: 2007-05-29
   Days after onset:0
Entered: 2007-06-04
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0388U / 1 LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Asthenia, Dizziness, Injection site reaction, Nausea, Pallor
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (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:
Allergies:
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Injection given and pt became weak, color drained from face and felt nauseated and faint. Pt did not faint- no LOC


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