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This is VAERS ID 281390

Case Details

VAERS ID: 281390 (history)  
Form: Version 1.0  
Age: 20.0  
Gender: Female  
Location: North Carolina  
Vaccinated:2007-06-06
Onset:2007-06-06
   Days after vaccination:0
Submitted: 2007-06-08
   Days after onset:2
Entered: 2007-06-12
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 05234 / 1 RA / IM

Administered by: Private       Purchased by: Unknown
Symptoms: Nausea, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Injection given complained of feeling nauseated, given juice, sprite with relief obtained, observed for 25-30 minutes to check out, fainted-treated per internist.


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