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This is VAERS ID 283930

Case Details

VAERS ID: 283930 (history)  
Form: Version 1.0  
Age: 24.0  
Gender: Female  
Location: New Jersey  
   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

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
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: 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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