Age: 12.0
Sex: F
Vaccine: FLUX, HPV4, MNQ, FLU3, HPV4, MNQ
Symptoms: Face injury, Fall, Ophthalmological examination, Skin laceration, Syncope
Clinical narrative: Information has been received from a physician and a nurse concerning a young female patient wear eyeglasses who one month ago was vaccinated with dose of GARDASIL (Lot # not provided). Physician reported that the patient fainted in his practice after receiving GARDASIL and MENACTRA and a third vaccine. The patient fainted and fell off the exam table. Physician stated that the patient "cut herself" because she was wearing glasses and had to have some stitches. The nurse stated the patient seemed fine, got a sucker and as the nurse walked out of the room the patient sitting on the exam table tumbled down. At the time of this report, the patient's outcome was unspecified. Follow-up information has been received via medical records from a physician and a registered nurse concerning a 12 year old female patient with asthma and minimal slight nasal allergy who on 13-JUL-2009 was vaccinated with the first dose of GARDASIL, her first dose of hepatitis A virus vaccine (unspecified) and her ADACEL. At this time she was scheduled for her second dose of GARDASIL, and MENACTRA. The registered nurse reported that on 14-SEP-2009 at 12:20 the patient was vaccinated into the right arm with the second 0.5 ml dose of GARDASIL (Lot # 662518/0087Y), into the left arm with the first 0.5 ml dose of MENACTRA (Lot # 42919AA) and into the left arm with the fourth 0.5 ml dose of influenza virus vaccine (unspecified). Concomitant therapy included albuterol, montelukast sodium (MSD), CLARITIN and NASONEX. The physician reported that her impression on the initial evaluation was that the child had mild allergies. At arrive the physical examination (Head Ears Eyes Nose Throat (HEENT) exam) showed membranes were normal though slightly thickened from previous infections. There was minimal slight nasal allergy. No postnasal drainage. No evidence of sinus infections and no pharyngitis. The patient was given the vaccines and within 60 seconds of received the vaccines, however, the patient had a sudden syncopal episode. On the previous time of her vaccinations, the child had wanted the doctor present and helping her with the vaccines. She felt more comfortable this time being the presence on the nurse and her mother. There were no problems giving the vaccines, but as noted above, she had a complete syncopal episode. The mother said she turned her head to the side to take care of the business part of the visit when she saw the patient falling forward onto the floor. The child fell forward, striking her forehead and glasses. Immediately the physician's staff arrived to care for her and noted that she had a bleeding around the right eye. Her glasses were broken. However, the right temporal part of the glasses was embedded or pinched into the skin of once of the laceration. After several minutes of working with a hemostat and forceps, the physician's staff was able to remove the temple part of the glasses from the skin. Further evaluation revealed that there were two lacerations, one 8 mm in length and one 7 mm in length. The top one was right at the level of the right eyebrow and seems to be fairly superficial. The one lower than this was a little deeper with some subcutaneous tissue being noted. The bleeding was stopped with pressure. The physician's staff then washed the lacerations completely. The physician repeated a HEENT exam. There was no evidence of eye damage and no evidence of ear problems and pupils were equal and reactive to light in accommodation. The lacerations were as noted above. There did not appear to be any further injuries outside of the two lacerations as noted above. The patient's blood pressure was checked after stabilized her and found to be 98/62. It should be noted that in July her blood pressure was 100/64. At the time of reporting the patient had recovered. Additional information is not expected.