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This is VAERS ID 284401

Case Details

VAERS ID: 284401 (history)  
Age: 14.0  
Gender: Female  
Location: Kansas  
Vaccinated:2007-07-09
Onset:2007-07-09
   Days after vaccination:0
Submitted: 2007-07-09
   Days after onset:0
Entered: 2007-07-12
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 0 LA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC528009AA / 5 RA / IM

Administered by: Private       Purchased by: Unknown
Symptoms: Blood pressure decreased, Nausea, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fainted/nausea/decreased BP - Trendelenberg used. Unable to get a B/P but pt was alert. B/P after 10 min was 100/58 (normal per pt)


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