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This is VAERS ID 281435

Case Details

VAERS ID: 281435 (history)  
Form: Version 1.0  
Age: 16.0  
Gender: Female  
Location: California  
Vaccinated:2007-06-11
Onset:2007-06-11
   Days after vaccination:0
Submitted: 2007-06-12
   Days after onset:1
Entered: 2007-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0523U / 1 RA / -

Administered by: Private       Purchased by: Other
Symptoms: Dizziness, Loss of consciousness, Malaise, Nausea, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (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: Sports Px
Preexisting Conditions: NKDA
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Within 10 minutes of injection, patient became light headed and passed out. Approximately 20 minutes after injection nausea and vomiting began. Sent to ER due to persistence of feeling ill.


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