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This is VAERS ID 283785

Case Details

VAERS ID: 283785 (history)  
Age: 13.0  
Gender: Female  
Location: California  
Vaccinated:2007-05-02
Onset:2007-05-02
   Days after vaccination:0
Submitted: 2007-06-14
   Days after onset:43
Entered: 2007-06-18
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / UN

Administered by: Private       Purchased by: Private
Symptoms: Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0705USA01610

Write-up: Information has been received from a nurse concerning a 13 year old female who on 02-MAY-2007 was vaccinated with the first dose of Gardasil. Ten minutes after receiving the vaccination, the patient passed out. Subsequently, the patient recovered on 02-MAY-2007 and was noted to be fine. Additional information has been requested. 07/08/2008 Initial and follow up information has been received from a nurse concerning a 13 year old female student who on 02-MAY-2007 was vaccinated with the first dose of GARDASIL. Ten minutes after receiving the vaccination, the patient passed out. Subsequently, the patient recovered on 02-MAY-2007 and was noted to be fine. In follow up information from the doctor''s office it was reported that patient felt very faint on 03-MAY-2008 (previously reported as patient passed out on 02-MAY-2008). She recovered on the same day. Additional information is not expected.


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