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This is VAERS ID 282735

Case Details

VAERS ID: 282735 (history)  
Form: Version 1.0  
Age: 18.0  
Gender: Female  
Location: Illinois  
Vaccinated:2007-06-21
Onset:2007-06-21
   Days after vaccination:0
Submitted: 2007-06-23
   Days after onset:2
Entered: 2007-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0012U / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2183AA / 1 LA / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Hypotension, Malaise, Musculoskeletal stiffness, Pallor, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received Gardasil. Three minutes after the vaccine was given she said: "I don''t feel good" Then she went pale, stiff, fainted. She didn''t recall what happened. She came back after 5 minutes. Her BP was low, 60/40 and received epi 0.3 mg.


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