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This is VAERS ID 275829

Case Details

VAERS ID: 275829 (history)  
Age: 17.0  
Gender: Female  
Location: Florida  
Vaccinated:2007-04-04
Onset:2007-04-04
   Days after vaccination:0
Submitted: 2007-04-04
   Days after onset:0
Entered: 2007-04-09
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0188U / 0 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1932AB / 0 RA / IM

Administered by: Private       Purchased by: Private
Symptoms: Blood glucose normal, Dizziness, Fatigue, Gait disturbance, Hypotension, Pallor, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: None/NKDA
Diagnostic Lab Data: Blood Glucose (normal)
CDC Split Type:

Write-up: Dizziness, pt stated that she was feeling tired, faint, could not walk, almost passed, pale face, low blood pressure. But she was conscious the whole time. The whole episode happened about 10 minutes after receiving the vaccines. She was monitored in the office until she was feeling better. She walked out of the office at 1230 PM. Received the shots at 1140.


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