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This is VAERS ID 284560

Case Details

VAERS ID: 284560 (history)  
Form: Version 1.0  
Age: 13.0  
Gender: Female  
Location: California  
Vaccinated:2007-02-01
Onset:2007-02-01
   Days after vaccination:0
Submitted: 2007-06-14
   Days after onset:132
Entered: 2007-06-18
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Computerised tomogram normal, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (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? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: computed axial - normal
CDC Split Type: WAES0706USA00047

Write-up: Information has been received from a staff member concerning her 13 year old daughter who in February 2007, was vaccinated with a first dose of Gardasil. Subsequently, the patient fainted after receiving the vaccine. It was reported that the patient recovered, but she fainted again 3 weeks later in school. Unspecified medical attention. Laboratory diagnostic studies included a CAT scan and was reported to be normal. On an unspecified date in April 2007 the patient received a second dose of Gardasil and did not faint. At the time of this report, the patient recovered. No product quality complaint was involved. Additional information has been requested.


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