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This is VAERS ID 281573

Case Details

VAERS ID: 281573 (history)  
Age: 15.0  
Gender: Female  
Location: Iowa  
Vaccinated:2007-06-13
Onset:2007-06-13
   Days after vaccination:0
Submitted: 2007-06-13
   Days after onset:0
Entered: 2007-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0244U / 0 LL / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2061AA / 0 RL / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Fall, Head injury, Pallor, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: no
Preexisting Conditions: None expressed in pre-screening
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was given two vaccines(Menactra and HPV) and she looked pale after administered the vaccine, thus this nurse had her rest several minutes on an exam table and then moved her to the hallway (waiting area) into a chair. This nurse returned to the vaccination room and heard a thump. Client was found on the floor with an episode of syncope for approximately 15 to 30 seconds and then became responsive to verbal stimuli. Client made to rest on the floor for a minute before getting up and then she returned to her chair for questioning. Client hit her head on the floor during her episode of syncope and thus was taken to the Emergency Department on the second floor of this hospital for evaluation where she was released after examination by Dr. No apparent injury noted.


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