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This is VAERS ID 284887

Case Details

VAERS ID: 284887 (history)  
Form: Version 1.0  
Age: 18.0  
Gender: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2007-07-06
Entered: 2007-07-13
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / IM

Administered by: Other       Purchased by: Other
Symptoms: Pallor
SMQs:, Hypotonic-hyporesponsive episode (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: Unknown
CDC Split Type: WAES0703USA03999

Write-up: Information has been received from a physician concerning an 18 year old female who was vaccinated with Gardasil. After receiving her second dose of vaccine, the patient from turned "ghost white." The patient sought unspecified medical attention. On an unspecified date, the patient recovered with turning "ghost white." This is one of several reports received from the same source. Additional information is not expected.


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