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This is VAERS ID 284581

Case Details

VAERS ID: 284581 (history)  
Form: Version 1.0  
Age: 9.0  
Gender: Female  
Location: Texas  
Submitted: 2007-06-14
Entered: 2007-06-18
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: 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: Nervousness
Preexisting Conditions:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0706USA01472

Write-up: Information has been received from a medical assistant concerning a 9 year old female who was vaccinated with the first dose of Gardasil. It was reported that the patient appeared to be nervous prior to vaccination, and subsequently, 5-10 seconds after vaccination the patient fainted. The patient''s mother caught her so that she did not fall and incur any additional injury. The patient sought unspecified medical attention. It took 5-10 minutes for the patient to fully recover, and then she was able to leave the office. Additional information has been requested. This is one of two reports received from the same source.

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