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This is VAERS ID 284651

Case Details

VAERS ID: 284651 (history)  
Age: 13.0  
Gender: Female  
Location: Pennsylvania  
Vaccinated:2007-05-10
Onset:2007-05-10
   Days after vaccination:0
Submitted: 2007-07-16
   Days after onset:67
Entered: 2007-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0388U / 0 LA / UN
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER 0368U / 1 RA / UN

Administered by: Unknown       Purchased by: Unknown
Symptoms: 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), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NA
Current Illness: No
Preexisting Conditions: Patient has a VSD with no restrictions that has never caused her any problems.
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: Patient passed out on our way out of the DR office. She did come to pretty quickly without assistance. She has not had this happen before after shots. She also had the Varinox #2 (Merck/0368U) shot that day - I couldn''t find it on the drop-down box below.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=284651


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