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This is VAERS ID 282952

Case Details

VAERS ID: 282952 (history)  
Form: Version 1.0  
Age: 18.0  
Gender: Female  
Location: Pennsylvania  
Vaccinated:2007-06-26
Onset:2007-06-26
   Days after vaccination:0
Submitted: 2007-06-27
   Days after onset:1
Entered: 2007-06-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0388U / 1 LA / -
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2276BA / 1 LA / -

Administered by: Private       Purchased by: Private
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), 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: Fainting~Vaccine not specified (no brand name)~~10.00~In Patient
Other Medications:
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Fainted after receiving injections. Per mom this is normal response after receiving injections occurs 10-15 min after that pt faints. Vital signs were stable.


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