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This is VAERS ID 281958

Case Details

VAERS ID: 281958 (history)  
Age: 11.0  
Gender: Female  
Location: Texas  
Vaccinated:2007-06-15
Onset:2007-06-15
   Days after vaccination:0
Submitted: 2007-06-15
   Days after onset:0
Entered: 2007-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0263U / 0 LA / IM

Administered by: Private       Purchased by: Public
Symptoms: Fall, 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? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient Recieved HPV vaccine in LA. Walked out of the clinic and building, tripped and fainted. Mom sent younger sister in to get me. We got a wheel chair and brought her back into the clinic, on the way in she fainted again. Got her on to the bed and took BP 106/57. After 5 min sat her up and retook BP 105/54. Got her to the wheel chair and gave her a drink of water and took her to the ER. Gave report to the ER nurse.


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