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This is VAERS ID 282395

Case Details

VAERS ID: 282395 (history)  
Form: Version 1.0  
Age: 16.0  
Gender: Female  
Location: New York  
Vaccinated:2007-05-17
Onset:2007-05-17
   Days after vaccination:0
Submitted: 2007-06-20
   Days after onset:34
Entered: 2007-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0210U / 1 LA / -

Administered by: Private       Purchased by: Unknown
Symptoms: Immediate post-injection reaction, Nausea, Syncope vasovagal, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (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? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Orthrotricylen Lo
Current Illness: none
Preexisting Conditions: NKA
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt was given injection and immediately had a vagal reaction. Followed by nausea with vomiting 15 minutes post injection.


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