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This is VAERS ID 273099

Case Details

VAERS ID: 273099 (history)  
Age: 13.0  
Gender: Female  
Location: New York  
Vaccinated:2007-02-22
Onset:2007-02-22
   Days after vaccination:0
Submitted: 2007-02-23
   Days after onset:1
Entered: 2007-02-27
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB141AA / 0 RA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1426F / 0 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2158AA / 0 LA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B007AA / 0 LA / IM

Administered by: Private       Purchased by: Public
Symptoms:
SMQs:

Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: records received 4/5/07-CBC:66 neutrophils. 24.6 lymphocytes.
CDC Split Type:

Write-up: None Stated 03/05/07-records received from facility: seen in ED for allergic reaction to vaccines. HX of cough, wheezing and SOB few hours prior to ED visit, symptoms began 30 minutes after vaccines. Initially returned to PCP with c/o chest tightness, difficulty breathing, treated with epipen and benadryl and sent to ED. No swelling of mouth, lips or tongue. Allergies to cat (owns a cat). Uses nasonex for nasal congestion. VS P: 141, resp 20 BP 130/91. Treated with solu medol and ranitidine. Tremors, difficulty breathing. PE unremarkable. Lungs clear, no rhonchi, no wheezes. Admitted for IV steroid treatment.


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