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This is VAERS ID 284159

Case Details

VAERS ID: 284159 (history)  
Age: 15.0  
Gender: Female  
Location: Texas  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2007-06-14
Entered: 2007-06-18
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Ophthalmological examination, 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Ophthalmological exam
CDC Split Type: WAES0705USA03795

Write-up: Information has been received from a physician concerning a 15 year old female patient who was vaccinated with a 0.5 ml dose of Gardasil. Subsequently, the patient fainted after receiving the vaccine. Unspecified medical attention was sought. Laboratory diagnostic studies included an eye exam. On an unspecified date, the patient recovered. No product quality complaint was involved. Additional information has been requested.


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