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This is VAERS ID 443784

Case Details

VAERS ID: 443784 (history)  
Age:   
Gender: Unknown  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2011-11-28
Entered: 2011-11-29
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN

Administered by: Unknown       Purchased by: Unknown
Symptoms: Depressed level of consciousness, Syncope
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), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Albuterol; Budesonide; Formoterol fumarate
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES1111USA02675

Write-up: Information has been received from health authority (local reference # NZL110109) concerning a patient (age and gender unknown) who on an unknown date was vaccinated with a dose of GARDASIL (lot number, route and dose not reported). Concomitant therapy included budesonide, formoterol fumarate and albuterol. On an unspecified date the patient experienced syncope and consciousness decreased. At the time of reporting the patient had not recovered. The reporter felt that syncope and consciousness decreased related to therapy with GARDASIL. Syncope and consciousness decreased were considered to be disabling by the agency. The original reporting source was not provided. No further information is available.


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