Age: 17.0
Sex: F
Vaccine: HPV4
Symptoms: Urine analysis abnormal, White blood cell count increased
Clinical narrative: Information has been received from a nurse concerning a 17 year old female who on an unknown date was vaccinated with the first dose of GARDASIL.  In the morning of 29-OCT-2008, the patient was vaccinated with the second dose of GARDASIL.  The nurse reported that the patient was fine after the first vaccine.  On 29-OCT-2008, 5 to 10 minutes after vaccination the patient left the office to go to school.  The patient passed out while she was driving and got into an accident.  The nurse stated that the patient sounded fine on the phone but she went to ER for check up. Initial and follow up information has been received from a nurse and medical records concerning a 17 year old female who on 27-AUG-2008 was vaccinated with the first dose (lot # 659184/0843X), intramuscularly to the left deltoid. The nurse reported that the patient wsa fine after the first vaccine. In the morning of 29-OCT-2008, the patient was vaccinated with the second dose of GARDASIL. On 29-OCT-2008, 5 to 10 minutes after vaccination the patient left the office to go to school. The patient passed out while she was driving and got into an accident. The nurse stated that the patient sounded fine on the phone but she went to ER for check up. Follow-up information obtained from medical records reported that the patient was driving her car from the clinic where she had just received her GARDASIL injection. About 15 minutes latre she "passed out" and atruck the vehicle in front of her while traveling approximately 25 miles per hour. The patient states she felt dizzy and then the next theing she rememberd is waking up and seeing that she had hit the car in front of her. The patient was restrained and the air bags deployed. The patient was complaining of moderate pain over the left side of the chest. Otherwise she denied any pain. She reported a mild headache. She denied any previous episodes. The patient had been evaluated in the emergency room 2 days priort for right upper quadrant pain which she reported had presently resolved. The patient denined feeling sick prior to the motor vehicle collision. The patient was reported to be alert, cooperative and in no acute distress with obvious mild discomfort from pain. There were no abrasions/lacerations on the chest, and no noted chest tenderness. She was reported to be anxious. hger blood pressure was 140/83, her pulse was 94, and her respiratory rate was 18. The patient had a normal chest x-ray, normal CT scan of the head, normal abdominal ultrasound, and normal ECG. Blood work showed an elevated white blood cell count of 8.9 and urinalysis showed bacteria >500. The patient was treated with TYLENOL and TORADOL. It was reported that the patients syncopal episode was likely vasovagal following the administration of GARDASIL. The patient was also diagnosed with urinary tract infection and was given a prescription for VICODIN. The patient was instructed to return to the emergency room for any worsening of symptoms. It was reported that the patient had recovered on an unspecified date. No additional information is available. All available medical records will be provided upon request.