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This is VAERS ID 479800

(NOTE: This result is from the 6/14/2014 version of the VAERS database)

Case Details

VAERS ID: 479800 (history)  
Form: Version .0  
Age: 14.0  
Sex: Female  
Location: Texas  
Submitted: 2012-12-29
Entered: 2012-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Insomnia, Migraine, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (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, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Asthma
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1212USA010600

Write-up: This spontaneous report as received from an office manager refers to a 14 years old female patient with asthma. The patient was vaccinated with 3 doses of GARDASIL (lot# not reported) on 16-JUN-2009, 19-AUG-2009 and 18-DEC-2009, respectively. Concomitant medications included ZYRTEC, SINGULAIR, PULMICORT, SYMBICORT, VERAMYST and doxycycline. Since receiving GARDASIL, the patient had experienced migraines, fainting spells and could not sleep. The patient was hospitalized at some point but there was no information about the hospitalization or the name of the hospital. The patient contacted the physician. The outcome of migraines, fainting spells and could not sleep was reported as not recovered. The relatedness for migraines, fainting spells and could not sleep was unknown for GARDASIL. Additional information has been requested.

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