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From the 11/26/2021 release of VAERS data:

This is VAERS ID 472685

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Case Details

VAERS ID: 472685 (history)  
Form: Version 1.0  
Age: 13.0  
Sex: Female  
Location: Georgia  
Vaccinated:2010-09-02
Onset:2012-09-22
   Days after vaccination:751
Submitted: 2012-10-27
   Days after onset:35
Entered: 2012-11-02
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS 0216V / 1 LA / IM

Administered by: Private       Purchased by: Other
Symptoms: Abasia, Abdominal pain upper, Crying, Haematemesis, Headache, Loss of consciousness, Muscle spasms, Panic attack, Pelvic pain, Urticaria
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dystonia (broad), Gastrointestinal haemorrhage (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations: Adverse event.~HPV (no brand name)~1~13.00~Patient
Other Medications: None
Current Illness: No
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Dr. gave 1st HPV 9-2-10. Within a few days, pt. passed out, in 2 weeks passed out again. Spit up blood, bad headaches, stomach ache, hives. Dr. gave her HPV shot; recommended booster in 1 month. She passed out a week later, had panic attack, bad headaches, stomach and pelvic pain, legs cramping up at night. Waking crying, couldn''t walk at first.


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