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This is VAERS ID 150622

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History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 150622
VAERS Form:
Age:13.0
Sex:Female
Location:Kansas
Vaccinated:2000-01-24
Onset:2000-01-24
Submitted:2000-01-28
Entered:2000-04-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HAVRIX / SMITHKLINE VHA576B9 / 0 LA / IM
TD: TD ADSORBED, ADULTS / CONNAUGHT LABS 0950740 / - RA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: CONVULS, HEADACHE, CONFUS, HYPERTENS, HOSTILITY

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Before leaving the clinic, the pt fainted and collapsed, falling backwards onto the floor. The pt was lying on the floor with symptoms of a seizure. Trembling and twitching were occurring of the hands and neck. The pt''s face was rigid and both eyes were o"pen. The duration of this episode was approximately 1 minute. Subsequently, the pt became combative (kept trying to get up), belligerent, and displayed disorientation as she did not recall getting vaccinations or where she was. Blood pressure was 130/80,


Changed on 12/30/2006

VAERS ID: 150622 Before After
VAERS Form:
Age:13.0
Sex:Female
Location:Kansas
Vaccinated:2000-01-24
Onset:2000-01-24
Submitted:2000-01-28
Entered:2000-04-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HAVRIX / SMITHKLINE VHA576B9 / 0 LA / IM
TD: TD ADSORBED, ADULTS / CONNAUGHT LABS 0950740 / - RA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: CONVULS, HEADACHE, CONFUS, HYPERTENS, HOSTILITY

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Before leaving the clinic, the pt fainted and collapsed, falling backwards onto the floor. The pt was lying on the floor with symptoms of a seizure. Trembling and twitching were occurring of the hands and neck. The pt''s pt''''s face was rigid and both eyes were o"pen. were"open. The duration of this episode was approximately 1 minute. Subsequently, the pt became combative (kept trying to get up), belligerent, and displayed disorientation as she did not recall getting vaccinations or where she was. Blood pressure was 130/80, 130/80


Changed on 12/8/2009

VAERS ID: 150622 Before After
VAERS Form:
Age:13.0
Sex:Female
Location:Kansas
Vaccinated:2000-01-24
Onset:2000-01-24
Submitted:2000-01-28
Entered:2000-04-05 2000-03-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HAVRIX HEP A (HAVRIX) / SMITHKLINE SMITHKLINE BEECHAM VHA576B9 576B9 / 0 LA / IM
TD: TD ADSORBED, ADULTS TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABS CONNAUGHT LABORATORIES 0950740 / - RA / IM

Administered by: Public      Purchased by: Unknown Public
Symptoms: Aggression, Convulsion, Disorientation, Fall, Headache, Heart rate increased, Hypertension, Intracranial pressure increased, Muscle rigidity, Muscle twitching, Syncope, Tremor, Vomiting, CONVULS, HEADACHE, CONFUS, HYPERTENS, HOSTILITY

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) KS200005

Write-up: Before leaving the clinic, the pt fainted and collapsed, falling backwards onto the floor. The pt was lying on the floor with symptoms of a seizure. Trembling and twitching were occurring of the hands and neck. The pt''''s pt''s face was rigid and both eyes were"open. were open. The duration of this episode was approximately 1 minute. Subsequently, the pt became combative (kept trying to get up), belligerent, and displayed disorientation as she did not recall getting vaccinations or where she was. Blood pressure was 130/80 130/80, pulse 100 and regular, pupils equal, and skin was warm and dry. Pt had a complaint of a headache. The pt was detained for approximately 15 minutes until symptoms improved. The pt left will all symptoms gone except the belligerent attitude. The parent was compliant with referral to the hospital emergency room so the pt may be examined by a physician. Following the exam the pt was sent home. The pt was doing well until about 10:00 PM when she started vomiting and had a complaint of a headache. She was taken back to the ER assessed and transported to a hospital in another city. It was reported she had surgery to relieve inter-cranial pressure. On 1/25/00, the pts father reported she was doing "OK" since the surgery.


Changed on 5/14/2017

VAERS ID: 150622 Before After
VAERS Form:
Age:13.0
Sex:Female
Location:Kansas
Vaccinated:2000-01-24
Onset:2000-01-24
Submitted:2000-01-28
Entered:2000-03-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 576B9 / 0 LA / IM
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES 0950740 / - RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Aggression, Belligerence, Convulsion, Disorientation, Fall, Headache, Heart rate increased, Hypertension, Intracranial pressure increased, Muscle rigidity, Muscle twitching, Syncope, Tremor, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': KS200005

Write-up: Before leaving the clinic, the pt fainted and collapsed, falling backwards onto the floor. The pt was lying on the floor with symptoms of a seizure. Trembling and twitching were occurring of the hands and neck. The pt''s face was rigid and both eyes were open. The duration of this episode was approximately 1 minute. Subsequently, the pt became combative (kept trying to get up), belligerent, and displayed disorientation as she did not recall getting vaccinations or where she was. Blood pressure was 130/80, pulse 100 and regular, pupils equal, and skin was warm and dry. Pt had a complaint of a headache. The pt was detained for approximately 15 minutes until symptoms improved. The pt left will all symptoms gone except the belligerent attitude. The parent was compliant with referral to the hospital emergency room so the pt may be examined by a physician. Following the exam the pt was sent home. The pt was doing well until about 10:00 PM when she started vomiting and had a complaint of a headache. She was taken back to the ER assessed and transported to a hospital in another city. It was reported she had surgery to relieve inter-cranial pressure. On 1/25/00, the pts father reported she was doing "OK" since the surgery.


Changed on 9/14/2017

VAERS ID: 150622 Before After
VAERS Form:(blank) 1
Age:13.0
Sex:Female
Location:Kansas
Vaccinated:2000-01-24
Onset:2000-01-24
Submitted:2000-01-28
Entered:2000-03-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 576B9 / 0 1 LA / IM
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES 0950740 / - UNK RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Aggression, Belligerence, Convulsion, Disorientation, Fall, Headache, Heart rate increased, Hypertension, Intracranial pressure increased, Muscle rigidity, Muscle twitching, Syncope, Tremor, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': KS200005

Write-up: Before leaving the clinic, the pt fainted and collapsed, falling backwards onto the floor. The pt was lying on the floor with symptoms of a seizure. Trembling and twitching were occurring of the hands and neck. The pt''s face was rigid and both eyes were open. The duration of this episode was approximately 1 minute. Subsequently, the pt became combative (kept trying to get up), belligerent, and displayed disorientation as she did not recall getting vaccinations or where she was. Blood pressure was 130/80, pulse 100 and regular, pupils equal, and skin was warm and dry. Pt had a complaint of a headache. The pt was detained for approximately 15 minutes until symptoms improved. The pt left will all symptoms gone except the belligerent attitude. The parent was compliant with referral to the hospital emergency room so the pt may be examined by a physician. Following the exam the pt was sent home. The pt was doing well until about 10:00 PM when she started vomiting and had a complaint of a headache. She was taken back to the ER assessed and transported to a hospital in another city. It was reported she had surgery to relieve inter-cranial pressure. On 1/25/00, the pts father reported she was doing "OK" since the surgery.


Changed on 2/14/2018

VAERS ID: 150622 Before After
VAERS Form:1
Age:13.0
Sex:Female
Location:Kansas
Vaccinated:2000-01-24
Onset:2000-01-24
Submitted:2000-01-28
Entered:2000-03-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 576B9 / 1 LA / IM
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES 0950740 / UNK RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Aggression, Belligerence, Convulsion, Disorientation, Fall, Headache, Heart rate increased, Hypertension, Intracranial pressure increased, Muscle rigidity, Muscle twitching, Syncope, Tremor, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': KS200005

Write-up: Before leaving the clinic, the pt fainted and collapsed, falling backwards onto the floor. The pt was lying on the floor with symptoms of a seizure. Trembling and twitching were occurring of the hands and neck. The pt''s face was rigid and both eyes were open. The duration of this episode was approximately 1 minute. Subsequently, the pt became combative (kept trying to get up), belligerent, and displayed disorientation as she did not recall getting vaccinations or where she was. Blood pressure was 130/80, pulse 100 and regular, pupils equal, and skin was warm and dry. Pt had a complaint of a headache. The pt was detained for approximately 15 minutes until symptoms improved. The pt left will all symptoms gone except the belligerent attitude. The parent was compliant with referral to the hospital emergency room so the pt may be examined by a physician. Following the exam the pt was sent home. The pt was doing well until about 10:00 PM when she started vomiting and had a complaint of a headache. She was taken back to the ER assessed and transported to a hospital in another city. It was reported she had surgery to relieve inter-cranial pressure. On 1/25/00, the pts father reported she was doing "OK" since the surgery.


Changed on 6/14/2018

VAERS ID: 150622 Before After
VAERS Form:1
Age:13.0
Sex:Female
Location:Kansas
Vaccinated:2000-01-24
Onset:2000-01-24
Submitted:2000-01-28
Entered:2000-03-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 576B9 / 1 LA / IM
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES 0950740 / UNK RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Aggression, Belligerence, Convulsion, Disorientation, Fall, Headache, Heart rate increased, Hypertension, Intracranial pressure increased, Muscle rigidity, Muscle twitching, Syncope, Tremor, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': KS200005

Write-up: Before leaving the clinic, the pt fainted and collapsed, falling backwards onto the floor. The pt was lying on the floor with symptoms of a seizure. Trembling and twitching were occurring of the hands and neck. The pt''s face was rigid and both eyes were open. The duration of this episode was approximately 1 minute. Subsequently, the pt became combative (kept trying to get up), belligerent, and displayed disorientation as she did not recall getting vaccinations or where she was. Blood pressure was 130/80, pulse 100 and regular, pupils equal, and skin was warm and dry. Pt had a complaint of a headache. The pt was detained for approximately 15 minutes until symptoms improved. The pt left will all symptoms gone except the belligerent attitude. The parent was compliant with referral to the hospital emergency room so the pt may be examined by a physician. Following the exam the pt was sent home. The pt was doing well until about 10:00 PM when she started vomiting and had a complaint of a headache. She was taken back to the ER assessed and transported to a hospital in another city. It was reported she had surgery to relieve inter-cranial pressure. On 1/25/00, the pts father reported she was doing "OK" since the surgery.


Changed on 8/14/2018

VAERS ID: 150622 Before After
VAERS Form:1
Age:13.0
Sex:Female
Location:Kansas
Vaccinated:2000-01-24
Onset:2000-01-24
Submitted:2000-01-28
Entered:2000-03-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 576B9 / 1 LA / IM
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES 0950740 / UNK RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Aggression, Belligerence, Convulsion, Disorientation, Fall, Headache, Heart rate increased, Hypertension, Intracranial pressure increased, Muscle rigidity, Muscle twitching, Syncope, Tremor, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': KS200005

Write-up: Before leaving the clinic, the pt fainted and collapsed, falling backwards onto the floor. The pt was lying on the floor with symptoms of a seizure. Trembling and twitching were occurring of the hands and neck. The pt''s face was rigid and both eyes were open. The duration of this episode was approximately 1 minute. Subsequently, the pt became combative (kept trying to get up), belligerent, and displayed disorientation as she did not recall getting vaccinations or where she was. Blood pressure was 130/80, pulse 100 and regular, pupils equal, and skin was warm and dry. Pt had a complaint of a headache. The pt was detained for approximately 15 minutes until symptoms improved. The pt left will all symptoms gone except the belligerent attitude. The parent was compliant with referral to the hospital emergency room so the pt may be examined by a physician. Following the exam the pt was sent home. The pt was doing well until about 10:00 PM when she started vomiting and had a complaint of a headache. She was taken back to the ER assessed and transported to a hospital in another city. It was reported she had surgery to relieve inter-cranial pressure. On 1/25/00, the pts father reported she was doing "OK" since the surgery.


Changed on 9/14/2018

VAERS ID: 150622 Before After
VAERS Form:1
Age:13.0
Sex:Female
Location:Kansas
Vaccinated:2000-01-24
Onset:2000-01-24
Submitted:2000-01-28
Entered:2000-03-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 576B9 / 1 LA / IM
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES 0950740 / UNK RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Aggression, Belligerence, Convulsion, Disorientation, Fall, Headache, Heart rate increased, Hypertension, Intracranial pressure increased, Muscle rigidity, Muscle twitching, Syncope, Tremor, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': KS200005

Write-up: Before leaving the clinic, the pt fainted and collapsed, falling backwards onto the floor. The pt was lying on the floor with symptoms of a seizure. Trembling and twitching were occurring of the hands and neck. The pt''s face was rigid and both eyes were open. The duration of this episode was approximately 1 minute. Subsequently, the pt became combative (kept trying to get up), belligerent, and displayed disorientation as she did not recall getting vaccinations or where she was. Blood pressure was 130/80, pulse 100 and regular, pupils equal, and skin was warm and dry. Pt had a complaint of a headache. The pt was detained for approximately 15 minutes until symptoms improved. The pt left will all symptoms gone except the belligerent attitude. The parent was compliant with referral to the hospital emergency room so the pt may be examined by a physician. Following the exam the pt was sent home. The pt was doing well until about 10:00 PM when she started vomiting and had a complaint of a headache. She was taken back to the ER assessed and transported to a hospital in another city. It was reported she had surgery to relieve inter-cranial pressure. On 1/25/00, the pts father reported she was doing "OK" since the surgery.


Changed on 10/14/2018

VAERS ID: 150622 Before After
VAERS Form:1
Age:13.0
Sex:Female
Location:Kansas
Vaccinated:2000-01-24
Onset:2000-01-24
Submitted:2000-01-28
Entered:2000-03-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 576B9 / 1 LA / IM
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES 0950740 / UNK RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Aggression, Belligerence, Convulsion, Disorientation, Fall, Headache, Heart rate increased, Hypertension, Intracranial pressure increased, Muscle rigidity, Muscle twitching, Syncope, Tremor, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': KS200005

Write-up: Before leaving the clinic, the pt fainted and collapsed, falling backwards onto the floor. The pt was lying on the floor with symptoms of a seizure. Trembling and twitching were occurring of the hands and neck. The pt''s face was rigid and both eyes were open. The duration of this episode was approximately 1 minute. Subsequently, the pt became combative (kept trying to get up), belligerent, and displayed disorientation as she did not recall getting vaccinations or where she was. Blood pressure was 130/80, pulse 100 and regular, pupils equal, and skin was warm and dry. Pt had a complaint of a headache. The pt was detained for approximately 15 minutes until symptoms improved. The pt left will all symptoms gone except the belligerent attitude. The parent was compliant with referral to the hospital emergency room so the pt may be examined by a physician. Following the exam the pt was sent home. The pt was doing well until about 10:00 PM when she started vomiting and had a complaint of a headache. She was taken back to the ER assessed and transported to a hospital in another city. It was reported she had surgery to relieve inter-cranial pressure. On 1/25/00, the pts father reported she was doing "OK" since the surgery.


Changed on 12/24/2020

VAERS ID: 150622 Before After
VAERS Form:1
Age:13.0
Sex:Female
Location:Kansas
Vaccinated:2000-01-24
Onset:2000-01-24
Submitted:2000-01-28
Entered:2000-03-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 576B9 / 1 LA / IM
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES 0950740 / UNK RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Aggression, Belligerence, Convulsion, Disorientation, Fall, Headache, Heart rate increased, Hypertension, Intracranial pressure increased, Muscle rigidity, Muscle twitching, Syncope, Tremor, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': KS200005

Write-up: Before leaving the clinic, the pt fainted and collapsed, falling backwards onto the floor. The pt was lying on the floor with symptoms of a seizure. Trembling and twitching were occurring of the hands and neck. The pt''s face was rigid and both eyes were open. The duration of this episode was approximately 1 minute. Subsequently, the pt became combative (kept trying to get up), belligerent, and displayed disorientation as she did not recall getting vaccinations or where she was. Blood pressure was 130/80, pulse 100 and regular, pupils equal, and skin was warm and dry. Pt had a complaint of a headache. The pt was detained for approximately 15 minutes until symptoms improved. The pt left will all symptoms gone except the belligerent attitude. The parent was compliant with referral to the hospital emergency room so the pt may be examined by a physician. Following the exam the pt was sent home. The pt was doing well until about 10:00 PM when she started vomiting and had a complaint of a headache. She was taken back to the ER assessed and transported to a hospital in another city. It was reported she had surgery to relieve inter-cranial pressure. On 1/25/00, the pts father reported she was doing "OK" since the surgery.


Changed on 12/30/2020

VAERS ID: 150622 Before After
VAERS Form:1
Age:13.0
Sex:Female
Location:Kansas
Vaccinated:2000-01-24
Onset:2000-01-24
Submitted:2000-01-28
Entered:2000-03-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 576B9 / 1 LA / IM
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES 0950740 / UNK RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Aggression, Belligerence, Convulsion, Disorientation, Fall, Headache, Heart rate increased, Hypertension, Intracranial pressure increased, Muscle rigidity, Muscle twitching, Syncope, Tremor, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': KS200005

Write-up: Before leaving the clinic, the pt fainted and collapsed, falling backwards onto the floor. The pt was lying on the floor with symptoms of a seizure. Trembling and twitching were occurring of the hands and neck. The pt''s face was rigid and both eyes were open. The duration of this episode was approximately 1 minute. Subsequently, the pt became combative (kept trying to get up), belligerent, and displayed disorientation as she did not recall getting vaccinations or where she was. Blood pressure was 130/80, pulse 100 and regular, pupils equal, and skin was warm and dry. Pt had a complaint of a headache. The pt was detained for approximately 15 minutes until symptoms improved. The pt left will all symptoms gone except the belligerent attitude. The parent was compliant with referral to the hospital emergency room so the pt may be examined by a physician. Following the exam the pt was sent home. The pt was doing well until about 10:00 PM when she started vomiting and had a complaint of a headache. She was taken back to the ER assessed and transported to a hospital in another city. It was reported she had surgery to relieve inter-cranial pressure. On 1/25/00, the pts father reported she was doing "OK" since the surgery.


Changed on 5/7/2021

VAERS ID: 150622 Before After
VAERS Form:1
Age:13.0
Sex:Female
Location:Kansas
Vaccinated:2000-01-24
Onset:2000-01-24
Submitted:2000-01-28
Entered:2000-03-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 576B9 / 1 LA / IM
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES 0950740 / UNK RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Aggression, Belligerence, Convulsion, Disorientation, Fall, Headache, Heart rate increased, Hypertension, Intracranial pressure increased, Muscle rigidity, Muscle twitching, Syncope, Tremor, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': KS200005

Write-up: Before leaving the clinic, the pt fainted and collapsed, falling backwards onto the floor. The pt was lying on the floor with symptoms of a seizure. Trembling and twitching were occurring of the hands and neck. The pt''s face was rigid and both eyes were open. The duration of this episode was approximately 1 minute. Subsequently, the pt became combative (kept trying to get up), belligerent, and displayed disorientation as she did not recall getting vaccinations or where she was. Blood pressure was 130/80, pulse 100 and regular, pupils equal, and skin was warm and dry. Pt had a complaint of a headache. The pt was detained for approximately 15 minutes until symptoms improved. The pt left will all symptoms gone except the belligerent attitude. The parent was compliant with referral to the hospital emergency room so the pt may be examined by a physician. Following the exam the pt was sent home. The pt was doing well until about 10:00 PM when she started vomiting and had a complaint of a headache. She was taken back to the ER assessed and transported to a hospital in another city. It was reported she had surgery to relieve inter-cranial pressure. On 1/25/00, the pts father reported she was doing "OK" since the surgery.


Changed on 5/21/2021

VAERS ID: 150622 Before After
VAERS Form:1
Age:13.0
Sex:Female
Location:Kansas
Vaccinated:2000-01-24
Onset:2000-01-24
Submitted:2000-01-28
Entered:2000-03-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 576B9 / 1 LA / IM
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES 0950740 / UNK RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Aggression, Belligerence, Convulsion, Disorientation, Fall, Headache, Heart rate increased, Hypertension, Intracranial pressure increased, Muscle rigidity, Muscle twitching, Syncope, Tremor, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': KS200005

Write-up: Before leaving the clinic, the pt fainted and collapsed, falling backwards onto the floor. The pt was lying on the floor with symptoms of a seizure. Trembling and twitching were occurring of the hands and neck. The pt''s face was rigid and both eyes were open. The duration of this episode was approximately 1 minute. Subsequently, the pt became combative (kept trying to get up), belligerent, and displayed disorientation as she did not recall getting vaccinations or where she was. Blood pressure was 130/80, pulse 100 and regular, pupils equal, and skin was warm and dry. Pt had a complaint of a headache. The pt was detained for approximately 15 minutes until symptoms improved. The pt left will all symptoms gone except the belligerent attitude. The parent was compliant with referral to the hospital emergency room so the pt may be examined by a physician. Following the exam the pt was sent home. The pt was doing well until about 10:00 PM when she started vomiting and had a complaint of a headache. She was taken back to the ER assessed and transported to a hospital in another city. It was reported she had surgery to relieve inter-cranial pressure. On 1/25/00, the pts father reported she was doing "OK" since the surgery.

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