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This is VAERS ID 284555

Case Details

VAERS ID: 284555 (history)  
Age: 16.0  
Gender: Female  
Location: Minnesota  
Vaccinated:2007-05-17
Onset:2007-05-17
   Days after vaccination:0
Submitted: 2007-06-14
   Days after onset:28
Entered: 2007-06-18
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / IM

Administered by: Private       Purchased by: Other
Symptoms: Hypotonia, Injection site pain, Loss of consciousness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), 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: Unknown
CDC Split Type: WAES0706USA00033

Write-up: This is in follow-up to report(s) previously submitted on 6/14/2007. Information has been received from a licensed practical nurse concerning a 16 year old female who was vaccinated IM with the second 0.5 ml dose of GARDASIL. On 17-MAY-2007 after receiving the vaccine the patient fainted and was unconscious for 1-2 minutes. The licensed practical nurse reported the patient complained of pain as injection was given and suddenly slumped in the chair. They were able to arouse the patient by calling her name. The staff watched the patient for 10-15 minutes after she was asked to lie down. The patient reported to the staff that she thought she was swimming. The patient recovered quickly and was clear and ambulatory when she left the clinic. The patient sought unspecified medical attention. No treatment was required. Subsequently, the patient recovered from fainting. The patient did not experience any adverse symptoms after the first dose. No additional information is expected.


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