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This is VAERS ID 259545

(NOTE: This result is from the 12/30/2006 version of the VAERS database)

Case Details

VAERS ID: 259545 (history)  
Form: Version .0  
Age: 14.0  
Sex: Female  
Location: D.C.  
Vaccinated:2006-07-11
Onset:2006-07-11
   Days after vaccination:0
Submitted: 2006-07-11
   Days after onset:0
Entered: 2006-07-14
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. 0637F / 0 RA / -

Administered by: Private       Purchased by: Unknown
Symptoms: Dehydration, Fall, Headache, Hyperventilation, Injection site pain
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: Allergic rhinitis, spring pollens/ragweed/dust/mold
Allergies:
Diagnostic Lab Data: LABS: WBC 11.7, neutros 84, lymphs 9.7.
CDC Split Type:

Write-up: Immediately after injection complained of severe pain at site. Fell off table and fainted for approximately 10 - 15 seconds. Hyperventilated and cried progressing Chvostek''''s sign in hands and feet. Rebreathing into a bag progressing to clearing of sympto"ms. Complained of headache, blurry vision; Vision test was normal. Vomiting x 1 in parking lot and speech was momentarily inarticulate. Sent to ER. At ER neuro exam was normal except for word recall /"coffee instead of coughing/" /"Sired instead of tired.


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20061230&IDNUMBER=259545


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