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This is VAERS ID 283844

Case Details

VAERS ID: 283844 (history)  
Age: 16.0  
Gender: Female  
Location: New Hampshire  
Vaccinated:2007-06-28
Onset:2007-06-28
   Days after vaccination:0
Submitted: 2007-06-28
   Days after onset:0
Entered: 2007-07-05
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0522U / - LA / IM

Administered by: Private       Purchased by: Public
Symptoms: Pallor, 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
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: Vitals
CDC Split Type:

Write-up: Pt was noted to be pale, pt fainted. Brought in room in lay. BP checked, Pulse checked. MD notified and checked Pt after resting BP elevated to normal. Pt released with mother to drive.


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