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This is VAERS ID 284460

Case Details

VAERS ID: 284460 (history)  
Age: 18.0  
Gender: Female  
Location: Ohio  
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. 1427F / 1 LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Body temperature, Dizziness, Loss of consciousness, Nausea
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (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: None
Diagnostic Lab Data: blood pressure, 05/07/07, stable; body temp, 05/07/07, OK
CDC Split Type: WAES0705USA04103

Write-up: Information has been received from a physician concerning a female who was vaccinated IM with the second dose of Gardasil. Subsequently the patient passed out within 5-10 minutes after receiving the vaccine. The patient went up to the circulation desk to pay before leaving and made it to the parking lot. The physician reported that the patient began to feel some nausea and dizziness so she came back into the physician''s office. It was unclear as to when and where the patient passed out. The physician reported that they had taken the patient''s blood pressure and let her rest while back in the office and someone came to pick her up . The patient''s outcome was not reported. Medical attention was sought. Additional information has been requested. 10/06/07 This is in follow-up to report(s) previously submitted on 6/14/2007. Information has been received from a physician concerning an 18 year old female with no prior history of drug reactions who was vaccinated intramuscularly into the left deltoid on 07-MAY-2007 at 09:15 AM with the second dose of GARDASIL. Subsequently, the patient passed out within 5-10 minutes after receiving the vaccine. The patient went up to the circulation desk to pay before leaving and made it to the parking lot. The physician reported that the patient began to feel some nausea and dizziness so she came back into the physician''s office. It was unclear as to when and where the patient passed out. The physician reported that they had taken the patient''s blood pressure and let her rest while back in the office and someone came to pick her up. Medical attention was sought. In additional information received on 11-JUL-2007, the attending physician reported that the patient felt dizzy and lightheaded secondary to the vaccine. Her blood pressure was stable and temperature was OK. On 07-MAY-2007, the patient recovered from the nausea, dizziness, syncope, and being lightheaded. No further information is expected.


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