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This is VAERS ID 294675

(NOTE: This result is from the 12/31/2007 version of the VAERS database)

Case Details

VAERS ID: 294675 (history)  
Form: Version .0  
Age: 14.0  
Gender: Female  
Location: Unknown  
Vaccinated:2007-10-26
Onset:2007-10-26
   Days after vaccination:0
Submitted: 2007-10-29
   Days after onset:3
Entered: 2007-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Apnoea, Asthenia, Dizziness, Gaze palsy, 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), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: None~ ()~~0~In Patient|None~ ()~~0~In Sibling
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC Split Type: None

Write-up: Within 10 minutes of receiving the Gardasil vaccination (she also received a flu shot in the other arm) patient said she felt like she was /"going to pass out/". The nurse had patient lay down on the examination table and brought up the leg support. Pat"ient''''s eyes rolled back in her head, her legs twitched, and she stopped breathing. She was unconscious for about 20 seconds. When I started screaming that Patient was not breathing, the nurse called a code in the office. Staff came with the equipment,


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20071231&IDNUMBER=294675


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