| VAERS ID: | 264204 | Vaccinated: | 2006-09-12 | | Age: | 15.0 | Onset: | 2006-09-13, Days after vaccination: 1 | | Gender: | Female | Submitted: | 2006-09-22, Days after onset: 9 | | Location: | Massachusetts | Entered: | 2006-10-10, Days after submission: 18 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: NONE | | Diagnostic Lab Data: At ER 9/13/06 EKG sinus arrhythmia, chest X ray NL, CT head normal, CBC, U/A, Lytes and toxic screen neg NL. | | Previous Vaccinations: | | Other Medications: Lithium, Propanolol, Prozac, Seraguel, Clozapine, Ritalin, Aviane, Keflex. | | Preexisting Conditions: Bipolar DS, ADHS, left hydronephrosis. | | CDC 'Split Type': | |
