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This is VAERS ID 284565

Case Details

VAERS ID: 284565 (history)  
Age: 16.0  
Gender: Female  
Location: New York  
Vaccinated:2007-01-18
Onset:2007-01-18
   Days after vaccination:0
Submitted: 2007-06-14
   Days after onset:146
Entered: 2007-06-18
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1162F / 0 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2159AA / 0 LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Asthenia, Dizziness, Pallor
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type: WAES0706USA00304

Write-up: Information has been received from a physician, via a company representative, concerning a 12 year old female patient, who was vaccinated with a dose Gardasil (date and dose not specified). The physician reported that the patient experienced dizziness after receiving the vaccination, and subsequently, recovered (duration not specified). Additional information has been requested. 10/08/07 This is in follow-up to report(s) previously submitted on 6/14/2007. Initial and follow up information has been received from a physician, concerning a 12 year old female patient, with no pertinent medical history or illness at the time of vaccination, who on 18-JAN-2007, was vaccinated IM in the right arm, with the first dose of GARDASIL (Lot #654540/1162F). Concomitant therapy included an IM vaccination in the left arm with the first dose of MENACTRA (Lot #U2159AA). The physician reported that the patient became dizzy/lightheaded, felt weak, and became very pale after receiving the vaccination. The patient was helped to a chair, and kept closing her eyes; she was then helped to lie down. Her blood pressure and blood glucose were "within acceptable limits" (values not provided), but each time she tried to get up, she would feel dizzy again and had to lie back down. She was given juice, and within approximately 15 minutes, she had recovered and was able to leave. No futher information is expected.


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