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This is VAERS ID 271932

Case Details

VAERS ID: 271932 (history)  
Form: Version 1.0  
Age: 14.0  
Gender: Female  
Location: Arizona  
Vaccinated:2007-02-07
Onset:2007-02-07
   Days after vaccination:0
Submitted: 2007-02-07
   Days after onset:0
Entered: 2007-02-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U22522A / 1 RA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0960F / 1 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR UE552AA / 1 LA / IM

Administered by: Other       Purchased by: Other
Symptoms: Blood glucose, Blood glucose normal, Blood pressure normal, Convulsion, Electrocardiogram, Electrocardiogram normal, Syncope vasovagal
SMQs:, Torsade de pointes/QT prolongation (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), 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:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: EKG, Blood sugar
CDC Split Type:

Write-up: Patient had a vasovagal syncopal episode with seizure seconds after receiving the vaccine. Checked blood sugar and BP and EKG and everything looked normal. Observed patient in clinic and no problems after.


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