National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 282964

Case Details

VAERS ID: 282964 (history)  
Form: Version 1.0  
Age: 18.0  
Gender: Female  
Location: Massachusetts  
Vaccinated:2007-06-18
Onset:2007-06-18
   Days after vaccination:0
Submitted: 2007-06-19
   Days after onset:1
Entered: 2007-06-27
   Days after submission:8
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 05220 / 1 LA / IM
TD: TD ADSORBED (NO BRAND NAME) / SANOFI PASTEUR C2720AA / 1 LA / IM

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:
Other Medications: on Ortho-tri-cyclen 1 tab PO QD
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Syncopal episode approx 5 min after administration


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=282964


Copyright © 2017 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166