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This is VAERS ID 281394

Case Details

VAERS ID: 281394 (history)  
Form: Version 1.0  
Age: 18.0  
Gender: Female  
Location: Pennsylvania  
Vaccinated:2007-06-08
Onset:2007-06-08
   Days after vaccination:0
Submitted: 2007-06-08
   Days after onset:0
Entered: 2007-06-12
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 - / -
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR - / 1 - / -

Administered by: Private       Purchased by: Private
Symptoms: Dizziness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), 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? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: syncope~Vaccine not specified (no brand name)~~0.00~In Patient|syncope~Vaccine not specified (no brand name)~~0.00~In Sibling
Other Medications: Benzaclea, Retina cream
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient became dizzy and syncopal and laid on table for 5 min. Blood pressure 100/50. Drank H2O. Walked out of office with mom 5 min later completely recovered.


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