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This is VAERS ID 271892

Case Details

VAERS ID: 271892 (history)  
Age: 12.0  
Gender: Female  
Location: Ohio  
Vaccinated:2007-02-05
Onset:2007-02-05
   Days after vaccination:0
Submitted: 2007-02-05
   Days after onset:0
Entered: 2007-02-07
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 1280F / 0 RA / -
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 00144 / 0 RA / -
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2157BA / 0 LA / -

Administered by: Private       Purchased by: Private
Symptoms: Fatigue, Feeling abnormal, Loss of consciousness, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

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

Write-up: Pt was receiving Gardasil, Hep A and Then Menactra. Right after administering the Menactra she said I feel funny and passed out. She was out for about 10 seconds. Then vomited 1x. Said she felt really tired.


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