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This is VAERS ID 268459

Case Details

VAERS ID: 268459 (history)  
Form: Version 1.0  
Age: 14.0  
Gender: Female  
Location: New Jersey  
   Days after vaccination:0
Submitted: 2006-12-06
   Days after onset:1
Entered: 2006-12-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Unknown       Purchased by: Unknown
Symptoms: Cold sweat, Difficulty in walking, Disorientation, Dizziness, Dyskinesia, Gait disturbance, Headache, Hyperventilation, Pallor, Paraesthesia, Tinnitus, Tremor
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Dementia (broad), Dyskinesia (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Eosinophilic pneumonia (broad), Hearing impairment (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: Shellfish
Diagnostic Lab Data: none
CDC Split Type:

Write-up: With in five minutes of administration complaint of headache, then felt faint. I had my daughter sit down in the waiting room with her head down before we walked out. Not thinking this had anything to do with the vaccine. We walked out the door and she began have difficlty walking, weaving, I asked her if she was okay and she could only respond yes. I took her arm and tried to turn her back to the Doctor''s office and she collapsed on the ground. Though, she remainded conscious her eyes were glazed and was disoriented. It happened that another lady was leaving the office and I asked for her assitance to walk her back inside. The nurse immediately had us put her on an exam table. I do not think she was able to hear a blood pressure. At this point, my daughter was extremely pale, clammy, shallow rapid breathing, weak pulse, able to anwser questions. She stated her ears were ringing and that she had tingling in her feet. The doctor naturally examined her as well. They treated her with oral fluids, rest and some sugar cookies(the only thing they had). I am not sure the exact time the vaccine was administered. I believe it was around 5pm. When we left the doctors office, it was 5:45, my daughter felt weak and was shaky (visible). On the drive home she experienced visible muscle contractions in her arms and legs. Legs and arms were involuntarily jerking. This lasted approximately 10 minutes. By 6:00pm she felt "normal".

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