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This is VAERS ID 280296

Case Details

VAERS ID: 280296 (history)  
Form: Version 1.0  
Age: 10.0  
Gender: Female  
Location: Indiana  
Vaccinated:2007-06-04
Onset:2007-06-04
   Days after vaccination:0
Submitted: 2007-06-04
   Days after onset:0
Entered: 2007-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1447F / 2 RA / IM

Administered by: Public       Purchased by: Public
Symptoms: Cold sweat, Dizziness, Malaise, Nausea, Pallor, Presyncope, Tinnitus, Vision blurred
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hearing impairment (narrow), 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:
Allergies:
Diagnostic Lab Data: None done
CDC Split Type:

Write-up: A few minutes after injection pt stated she didn''t feel well. Pt put head down between legs, c/o nausea. Pt looked up and was completely pale, c/o blurred vision, ringing in ears, dizzy, clammy, lightheaded. Assisted pt to car and transported to ER. Was dx as pre-syncope and drink fluids was discharged at 15:00


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