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This is VAERS ID 336766

Case Details

VAERS ID:336766 (history)  Vaccinated:0000-00-00
Age:15.0  Onset:0000-00-00
Gender:Female  Submitted:2008-12-12
Location:California  Entered:2008-12-15, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Therapy unspecified
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0811USA00691
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC. 1UNUN
Administered by: Other     Purchased by: Other
Symptoms: Head injury, Nodule, 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)
Write-up: Information has been received from a physician concerning a 15 year old female who was vaccinated with the second dose of GARDASIL. Concomitant medication included other unspecified vaccines. About 2 months ago, in approximately September 2008, the patient experienced fainted, hit the back of her head and got a lump. On an unspecified date in 2008, the patient recovered. Additional information has been requested.

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