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This is VAERS ID 284168

Case Details

VAERS ID: 284168 (history)  
Age:   
Gender: Female  
Location: Arkansas  
Vaccinated:2007-05-07
Onset:2007-05-07
   Days after vaccination:0
Submitted: 2007-06-14
   Days after onset:38
Entered: 2007-06-18
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: 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: None
CDC Split Type: WAES0705USA03903

Write-up: Information has been received from a physician, via a company representative, concerning a female patient, who on approximately 07-MAY-2007 ("about 2 weeks ago"), was vaccinated IM with a dose, 0.5ml, of Gardasil. The physician reported that on 07-MAY-2007, "the patient fainted right after receiving Gardasil," and confirmed that the patient had recovered (date unspecified). The patient sought unspecified medical attention. No further information is available.


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