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This is VAERS ID 283930

Case Details

VAERS ID: 283930 (history)  
Age: 24.0  
Gender: Female  
Location: New Jersey  
Vaccinated:2007-04-23
Onset:2007-04-23
   Days after vaccination:0
Submitted: 2007-06-14
   Days after onset:52
Entered: 2007-06-18
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 0 AR / IM

Administered by: Private       Purchased by: Private
Symptoms: Blood pressure, 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Blood pressure 04/23/07 130/70.
CDC Split Type: WAES0705USA02126

Write-up: This is in follow-up to report (s) previously submitted on 6/14/2007. Information has been received from a registered nurse concerning a 24 year old female teacher (weight 133#, height 62") who on 23-APR-2007 was vaccinated with the first dose (also reported as the second dose) of GARDASIL (lot #657617/0384U), IM in the deltoid. Concomitant medication was not reported. On 23-APR-2007 approximately 5 minutes after vaccine was administered, the patient fainted. The patient was treated with a cold pack to her head and she was instructed to lie down. The patient''s blood pressure was 130/70. Subsequently that same day, the patient recovered from fainting and left the physicians office unassisted. Additional information has been requested.


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