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This is VAERS ID 272196

Case Details

VAERS ID: 272196 (history)  
Age: 16.0  
Gender: Female  
Location: New York  
Vaccinated:2007-02-07
Onset:2007-02-07
   Days after vaccination:0
Submitted: 2007-02-13
   Days after onset:6
Entered: 2007-02-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB115BA / - - / -
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / - - / -

Administered by: Private       Purchased by: Unknown
Symptoms: Blood pressure decreased, Fall, Head injury, Loss of consciousness, Scan brain, Tremor
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Allergic to Ceclor
Diagnostic Lab Data: Brain/C spin CT negative.
CDC Split Type:

Write-up: Approx 2-5 minutes after receiving vaccines patient passed out while getting dressed. There was no witness to the event. Patient lost consciousness and fell from the seated position hitting head in 3 places. Blood pressure had dropped. Patient had a short episode of tremors during the recovery phase. Patient was allowed to rest and rehydrate until blood pressure returned to normal (100/80) 30 minutes later.


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