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This is VAERS ID 307011

Case Details

VAERS ID:307011 (history)  Vaccinated:2008-03-08
Age:15.0  Onset:2008-03-08, Days after vaccination: 0
Gender:Female  Submitted:2008-03-13, Days after onset: 4
Location:Georga  Entered:2008-03-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Fainting~ ()~~0~In Patient
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB217BA IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1508U1IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Pain in extremity, Pallor, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Administered HPV (Gardasil) vaccine #1 in child''s left deltoid. Patient fainted. I put ammonia under her nose. She woke up but was very pale and complained of her legs hurting. She then put her head between her legs and she began to feel better.

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