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This is VAERS ID 282369

Case Details

VAERS ID: 282369 (history)  
Form: Version 1.0  
Age: 17.0  
Gender: Female  
Location: Wisconsin  
Vaccinated:2007-06-11
Onset:2007-06-11
   Days after vaccination:0
Submitted: 2007-06-19
   Days after onset:8
Entered: 2007-06-20
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK - / IM

Administered by: Other       Purchased by: Other
Symptoms: Convulsion, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (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: None
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC Split Type: WAES0706USA01961

Write-up: Information has been received from a registered nurse concerning her 17 year old daughter with no relevant medical history reported who on 11-JUN-2007 was vaccinated intramuscularly with a 0.5 ml dose of Gardasil. There was no concomitant medication. On 11-JUN-2007, the patient fainted and "exhibited seizure like behavior" after receiving Gardasil. The patient sought unspecified medical attention. Subsequently, the patient recovered on 11-JUN-2007. Upon internal review, the patient''s convulsion was considered an other important medical event. Additional information has been requested.


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