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This is VAERS ID 284205

Case Details

VAERS ID: 284205 (history)  
Form: Version 1.0  
Age: 14.0  
Gender: Female  
Location: North Carolina  
Vaccinated:2007-07-09
Onset:2007-07-09
   Days after vaccination:0
Submitted: 2007-07-09
   Days after onset:0
Entered: 2007-07-10
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0181U / 2 LA / UN

Administered by: Private       Purchased by: Private
Symptoms: Syncope, Tremor, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None
CDC Split Type: NC07075

Write-up: Within 5 sec after giving shot, child started shaking, unresponsive for 15-30 sec then fainted.


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