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This is VAERS ID 280723

Case Details

VAERS ID: 280723 (history)  
Age: 19.0  
Gender: Female  
Location: Maryland  
Vaccinated:2007-05-21
Onset:2007-05-21
   Days after vaccination:0
Submitted: 2007-06-06
   Days after onset:16
Entered: 2007-06-07
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0211U / 1 LA / IM

Administered by: Private       Purchased by: Other
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Allergic to Bactrim
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was administered her 2nd dose of Gardasil on 5/21/07. After 10 minutes the patient was exiting the office and experienced syncope.


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