Age: 13.0
Sex: F
Vaccine: UNK
Symptoms: Heart rate decreased, Presyncope
Clinical narrative: Dizziness(Felt dizzy); Turned blue; Distress; Vagal Reaction; This case was reported in a literature article and described the occurrence of dizziness in a 13-year-old female patient who received HPV 16-18 (HPV vaccine unknown) for prophylaxis.   On an unknown date, the patient received HPV vaccine unknown at an unknown dose. On an unknown date, less than a day after receiving HPV vaccine unknown, the patient experienced dizziness (serious criteria hospitalization), cyanosis (serious criteria hospitalization), emotional distress (serious criteria hospitalization) and vagal reaction (serious criteria hospitalization). On an unknown date, the outcome of the dizziness, cyanosis, emotional distress and vagal reaction were unknown.   The reporter considered the dizziness, cyanosis, emotional distress and vagal reaction to be related to HPV vaccine unknown.  Additional details were reported as follows: This case was reported in a literature article and described occurrence of dizziness; fetal position, turned blue, vagal reaction and  distress, in a 13- year-old patient who was vaccinated with unspecified human papilloma virus (HPV) vaccine and unspecified meningococcal vaccine (MENO vaccine) (manufacturer unknown for both) for prophylaxis. This case corresponds to figure 2 reported in this literature article. The patient was a part of a descriptive study that was conducted to characterized public posts about the HPV vaccine and quantify the impact of sentiment and context on engagement via likes. By using analytic method at the beginning 30th April, 2018, through 20th August, 2018, publicly available posts (n = 29,763 posts) were collected although the final sample included posts that were created as far back as November 2, 2011, because API did not have a retrospective time limit on data collection. For the study inclusion criteria included, unique (not duplicates post, languages post, working link URL, text mentions HPV, specific to the HPV vaccine. Out of total 29,763, of 3, 378 posts were eligible. Our final analytic sample include 360 posts (as coded non-purposive post]. No information on patient's medical history or family history or concurrent condition or concomitant medication was provided. On unspecified date, at the age of 13 years, the patient had received unspecified HPV vaccine and unspecified meningococcal vaccine in the morning (administration site and route unspecified; dosage unknown; batch number not provided for both). On an unspecified date, at the age of 13 years, on the same day after vaccination, when the patient was leaving, the patient felt dizzy got into the car and went into a fetal position and turned blue. The patient's parent notified to the doctor office they ran out and started examination of the patient. The examination revealed the patient's heart rate dropped to 52 beats per minute and the patient was in distress. The patient was taken to hospital by ambulance and was hooked into an electrocardiogram (EKG) and blood work (result not provided for both). It was reported that the pedestrian said that it was a vaccine reaction, however hospital was saying that the patient had vagal reaction and discrediting vaccine reaction. This case was posted by friend of patient's parent on social media. This case has been considered as serious due to Hospitalization. Treatment was unknown.  The outcome of the event was not reported. The author commented, "The final analytic sample comprised 360 unique posts from 292 users. Of the 1,200 randomly sampled posts, 979 (81.6%) had active links, and one in three (n = 360 out of 979; 36.8% posts with working links) was relevant to the HPV vaccine. The author concluded, "On social media, discussions about HPV vaccination are often characterized by emotionally charged expressions of personal beliefs, personal narratives, information, and misinformation. Pro-vaccine posts are more prevalent on social media and anti-vaccine posts have higher engagement. We found that personal narratives about HPV vaccination were more likely to promote anti-vaccine sentiment and were produced more often by individual users who were not health-related or health professionals. At the same time, we observed that posts from health-related sources were predominantly in favor of the HPV vaccine, but posted pro-vaccine personal narratives far less often than information or resources. Provaccine narratives tended to show individuals who had recently received the vaccine, but rarely provided long-term details about their experience with vaccination, such as recognition or appreciation of an individual's personal role in life-long cancer prevention, highlighting stark contrasts with the depth and scope of details included in anti-vaccine personal narrative posts. Within the context of HPV vaccination, our research contributes meaningfully to gaps in the study of misinformation on social media by offering an estimate for the prevalence of misinformation on social media, as quantified by the proportion of anti-vaccine posts, and we also identified important characteristics of misinformation-containing anti-vaccine posts. More broadly, by equipping Provaccine advocates with concrete recommendations to improve the engagement, via likes, of their social media content, our findings may apply to combatting vaccine hesitancy in general, an emerging and global health threat identified recently by the World Health Organization.  With sufficient resources, organizations such as patient advocacy groups, health departments, and government agencies could create a portfolio of positive pro-vaccine narratives with accompanying visuals (e.g., photo) to disseminate, filling an essentially unoccupied field of content".      Lab Comments: Lab test done on unknown date.