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This is VAERS ID 274635

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 274635
Age:12.0
Gender:Female
Location:Wisconsin
Vaccinated:2007-03-22
Onset:2007-03-22
Submitted:2007-03-23
Entered:2007-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1426F / 0 RA / IM
TDAP: TDAP (ADACEL) / AVENTIS PASTEUR C2457AA / 0 LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Blood pressure, Chills, Confusional state, Dizziness, Muscle contracture

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE per parent~~NULL~~In Patient|NONE per parent~~NULL~~In Sibling1|NONE per parent~~NULL~~In Sibling2
Other Medications: None
Current Illness: No
Preexisting Conditions: None noted on vaccine history form completed by mother before immunizations given
Diagnostic Lab Data:
CDC 'Split Type': None noted on vaccine history form completed by mother before immunizations given

Write-up:Adacel given first, appeared fine. HPV then given and within a minute or two, client''''s chin fell to chest while arm contracted at elbow up off lap. She did not respond to name or shaking of shoulders for approximately one minute (B/P 100/60, pulse 64)."Then became aroused, although very confused and unsure where she was. Called out for her mom and asked where she was and said she felt dizzy. Client then assisted off chair to floor. Became extremely pale, c/o lips tingling, B/P 130/64 at 1800. While


Changed on 12/8/2009

VAERS ID: 274635 Before After
Age:12.0
Gender:Female
Location:Wisconsin
Vaccinated:2007-03-22
Onset:2007-03-22
Submitted:2007-03-23
Entered:2007-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1426F / 0 RA / IM
TDAP: TDAP (ADACEL) / AVENTIS PASTEUR C2457AA / 0 LA / IM

Administered by: Public      Purchased by: Unknown Public
Symptoms: Blood pressure, Chills, Confusional state, Dizziness, Pallor, Paraesthesia, Posture abnormal, Sensation of heaviness, Unresponsive to stimuli, Oxygen supplementation, Paraesthesia oral, Muscle contracture

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE per parent~~NULL~~In Patient|NONE per parent~~NULL~~In Sibling1|NONE per parent~~NULL~~In Sibling2
Other Medications: None
Current Illness: No
Preexisting Conditions: None noted on vaccine history form completed by mother before immunizations given
Diagnostic Lab Data:
CDC 'Split Type': None noted on vaccine history form completed by mother before immunizations given (blank)

Write-up:Adacel given first, appeared fine. HPV then given and within a minute or two, client''''s client''s chin fell to chest while arm contracted at elbow up off lap. She did not respond to name or shaking of shoulders for approximately one minute (B/P 100/60, pulse 64)."Then 64). Then became aroused, although very confused and unsure where she was. Called out for her mom and asked where she was and said she felt dizzy. Client then assisted off chair to floor. Became extremely pale, c/o lips tingling, B/P 130/64 at 1800. While resting c/o "heavy head" feeling and paresthia in R arm, R and L hands and feet as well as c/o of chills. At 1805 EMS called and responded by 1810 (B/P 130/66, RR 18 at 1805). Given oxygen per EMS. Client transported to ER. Client discharged from ER within a couple hours. Parent contacted at 2000 and states client was "fine now". Returned to school on 3/23/07 per mother.


Changed on 5/14/2017

VAERS ID: 274635 Before After
Age:12.0
Gender:Female
Location:Wisconsin
Vaccinated:2007-03-22
Onset:2007-03-22
Submitted:2007-03-23
Entered:2007-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1426F / 0 RA / IM
TDAP: TDAP (ADACEL) / AVENTIS PASTEUR SANOFI PASTEUR C2457AA / 0 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Blood pressure, Chills, Confusional state, Dizziness, Pallor, Paraesthesia, Posture abnormal, Sensation of heaviness, Unresponsive to stimuli, Oxygen supplementation, Paraesthesia oral, Muscle contracture

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE per parent~~NULL~~In parent~ ()~NULL~~In Patient|NONE per parent~~NULL~~In parent~ ()~NULL~~In Sibling1|NONE per parent~~NULL~~In parent~ ()~NULL~~In Sibling2
Other Medications: None
Current Illness: No
Preexisting Conditions: None noted on vaccine history form completed by mother before immunizations given
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Adacel given first, appeared fine. HPV then given and within a minute or two, client''s chin fell to chest while arm contracted at elbow up off lap. She did not respond to name or shaking of shoulders for approximately one minute (B/P 100/60, pulse 64). Then became aroused, although very confused and unsure where she was. Called out for her mom and asked where she was and said she felt dizzy. Client then assisted off chair to floor. Became extremely pale, c/o lips tingling, B/P 130/64 at 1800. While resting c/o "heavy head" feeling and paresthia in R arm, R and L hands and feet as well as c/o of chills. At 1805 EMS called and responded by 1810 (B/P 130/66, RR 18 at 1805). Given oxygen per EMS. Client transported to ER. Client discharged from ER within a couple hours. Parent contacted at 2000 and states client was "fine now". Returned to school on 3/23/07 per mother.


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