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This is VAERS ID 302709

Case Details

VAERS ID: 302709 (history)  
Form: Version 1.0  
Age: 15.0  
Gender: Female  
Location: Unknown  
Vaccinated:2007-12-31
Onset:2007-12-31
   Days after vaccination:0
Submitted: 2008-01-14
   Days after onset:14
Entered: 2008-01-15
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Computerised tomogram normal, Head injury, Loss of consciousness, Syncope, X-ray
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), Accidents and injuries (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Liver transplant
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: computed axial - head and neck - no results reported; X-ray - no results reported
CDC Split Type: WAES0801USA00501

Write-up: Information has been received from a mother concerning her 15 year old daughter who has had a liver transplant. There were multiple concomitant medications but none were specified. On 31-DEC-2007 the patient was vaccinated with her first dose of Gardasil. The mother reported that her daughter fainted within 10 minutes after receiving the vaccination. She passed out for about 1 minute after hitting her head. She was seen in the emergency room and required 7 staples in her head to close the wound she received. A CT of the head and neck was performed, as well as X-rays. No results were reported. Her head injury was considered to be immediately life-threatening and disabling. Additional information has been requested.


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