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This is VAERS ID 281112

Case Details

VAERS ID: 281112 (history)  
Form: Version 1.0  
Age:   
Gender: Female  
Location: Pennsylvania  
Vaccinated:2007-05-25
Onset:2007-05-25
   Days after vaccination:0
Submitted: 2007-06-05
   Days after onset:11
Entered: 2007-06-11
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0244U / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2234AA / 1 LA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR 2644AA / 1 LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Syncope, Tremor
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), 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: None
Current Illness: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Had Syncopal episode lasting 5 seconds immediately following injections (3). Brief shaking associated with syncope. PMH - similar episode when treated for ingrown toenail.


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