This is VAERS ID 259545
First Appeared on 12/30/2006 |
| VAERS ID: |
259545
|
Vaccinated: |
2006-07-11 |
| Age: |
14.0 |
Onset: |
2006-07-11 |
| Gender: |
Female |
Submitted: |
2006-07-11 |
| Location: |
D.C. |
Entered: |
2006-07-14 |
|
| Life Threatening? No |
| Died? No |
| Permanent Disability? No |
| Recovered? Yes |
| ER or Doctor Visit? Yes |
| Hospitalized? Yes, days: 1 |
| Extended hospital stay? No |
| Previous Vaccinations: |
| Other Medications: NONE |
| Current Illness: |
| Preexisting Conditions: Allergic rhinitis, spring pollens/ragweed/dust/mold |
| Diagnostic Lab Data: LABS: WBC 11.7, neutros 84, lymphs 9.7. |
| CDC 'Split Type': |
|
| Vaccination |
Manufacturer |
Lot |
Dose |
Route |
Site |
| 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 |
| 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. |
|
|
Changed on 12/8/2009 |
| VAERS ID: |
259545 Before
After
|
Vaccinated: |
2006-07-11 |
| Age: |
14.0 |
Onset: |
2006-07-11 |
| Gender: |
Female |
Submitted: |
2006-07-11 |
| Location: |
D.C. |
Entered: |
2006-07-14 |
|
| Life Threatening? No |
| Died? No |
| Permanent Disability? No |
| Recovered? Yes |
| ER or Doctor Visit? Yes |
| Hospitalized? Yes, days: 1 |
| Extended hospital stay? No |
| Previous Vaccinations: |
| Other Medications: NONE |
| Current Illness: |
| Preexisting Conditions: Allergic rhinitis, spring pollens/ragweed/dust/mold |
| Diagnostic Lab Data: LABS: WBC 11.7, neutros 84, lymphs 9.7. |
| CDC 'Split Type': |
|
| Vaccination |
Manufacturer |
Lot |
Dose |
Route |
Site |
| HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL)/HPV (GARDASIL) |
MERCK & CO. INC. |
0637F |
0 |
|
RA |
|
| Administered by: Private
Purchased by: Unknown/Private |
| Symptoms: Dehydration, Fall, Headache, Hyperventilation, Injection site pain, Laboratory test abnormal, Muscle spasms, Speech disorder, Syncope, Vision blurred, Vomiting |
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 Chvostek''s sign in hands and feet. Rebreathing into a bag progressing to clearing of sympto"ms. symptoms. 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 "coffee instead of coughing/" /"Sired coughing" "Sired instead of tired. tired." Continued complaint of headache. Vomited x 2. All symptoms spontaneously cleared approximately 6 hours after incident. Overnight hospitalization for observation. Neurological evaluation before discharge was normal. Diagnosis also included dehydration. No fluids were taken from 7/10/2006 PM until IV in ER. Anion gap noted on chemistries and concentration of urine obtained after several hours of hydration. Discharge diagnosis: Dehydration, Vasovagal syncope secondary to shot vs pain at injection site. 7/17/06 Medical records received from reporter/provider which included vax record, office note of 7/11 & neuro consult of 7/15 by MD who also saw her in the hospital on 7/11-12. Neuro report indicates the CT scan of head was WNL & that dx is syncope probably precipitated by pain of vax injection along w/dehydration (no fluid intake since evening of 7/10 until IVF given in ER). As of 7/15 patient continued to have throbbing HA when bending down & also c/o strong heart beats ocassionally. PMH: dehydration requiring hospitalization at age 3 yo. Also has hx of mild anxiety. Family hx: patient''s mother has Fuch''s disease (genetic degenertive corneal disease which her mother also had) & patient''s father has depression. There are no siblings. It was noted that she had 3 episodes of emesis following vax along w/ sustaining mild concussion when fell from exam table which was characterized by brief episode of aphasia, slurred speech & possible right facial paresis noted only by patient''s mother./ss 10/27/06 Received medic
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Link To This Search Result:
http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=259545&WAYBACKHISTORY=ON
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