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This is VAERS ID 284533

Case Details

VAERS ID: 284533 (history)  
Form: Version 1.0  
Age: 17.0  
Gender: Female  
Location: Georgia  
Vaccinated:2007-05-30
Onset:2007-05-30
   Days after vaccination:0
Submitted: 2007-06-14
   Days after onset:15
Entered: 2007-06-18
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR - / UNK UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Injection site pain, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (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), Extravasation events (injections, infusions and implants) (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0705USA05718

Write-up: Information has been received from a nurse concerning a 17 year old female who 30-MAY-2007 was vaccinated with a dose of Gardasil. The patient was concomitantly vaccinated with a dose of Menactra. The patient reported to the nurse that the Gardasil injection was more painful than Menactra. Subsequently, the patient passed out in the waiting room after Gardasil. The patient sought unspecified medical attention. The patient recovered from the event on 30-MAY-2007. No further information is available.


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