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This is VAERS ID 282251

Case Details

VAERS ID: 282251 (history)  
Form: Version 1.0  
Age: 18.0  
Gender: Female  
Location: Kentucky  
Vaccinated:2007-06-12
Onset:2007-06-12
   Days after vaccination:0
Submitted: 2007-06-13
   Days after onset:1
Entered: 2007-06-19
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0244U / 2 LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Blood glucose increased, Blood pressure decreased, Hyperhidrosis, Immediate post-injection reaction, Nausea, Pallor, Retching, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), 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: Zyrtec, Depo Provera
Current Illness: none
Preexisting Conditions: none known/environmental allergies
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt in to get Gardasil and Depo hot. Pt given Depo 1st, then Gardasil. Immediately after Gardasil pt became nauseated, dry heaving, syncopal, BP dropped to 60 could not hear bottom number, HR 60, pale, diaphoretic. Pt aroused somewhat with ammonia. Blood sugar 107. Pt did state she had not eaten this morning. Pt taken to in house ER where she was given a liter of LR, B/P increased pt improved and was discharged home.


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