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This is VAERS ID 321093

Case Details

VAERS ID: 321093 (history)  
Age: 13.0  
Gender: Female  
Location: Tennessee  
Vaccinated:2008-07-23
Onset:2008-07-23
   Days after vaccination:0
Submitted: 2008-08-01
   Days after onset:9
Entered: 2008-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER 1740U 8/10 / 1 RA / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Fall, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:

Write-up: After receiving Gardasil patient fainted and fell to floor. Patient''s vital signs were taken and monitored for about 30 mins after episode.


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