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This is VAERS ID 270235

Case Details

VAERS ID: 270235 (history)  
Form: Version 1.0  
Age: 17.0  
Gender: Female  
Location: Wisconsin  
Vaccinated:2007-01-03
Onset:2007-01-03
   Days after vaccination:0
Submitted: 2007-01-03
   Days after onset:0
Entered: 2007-01-09
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0961F / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2108AA / 1 LA / ID

Administered by: Private       Purchased by: Private
Symptoms: Blood pressure decreased, Dizziness, Hyperhidrosis, Nausea, Pallor
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (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: Prozac, Trisprintac
Current Illness:
Preexisting Conditions: Depression
Allergies:
Diagnostic Lab Data: Labs drawn just prior to vaccines (routine).
CDC Split Type:

Write-up: Patient received vaccines, then felt nauseous, dizzy, was pale and diaphoretic, BP decreased to 80/50, pt placed supine with feet elevated, given Benadryl 20 mg PO, sips water, felt better after about 1 hour.


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