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This is VAERS ID 276352

Case Details

VAERS ID: 276352 (history)  
Form: Version 1.0  
Age: 16.0  
Gender: Female  
Location: New Hampshire  
Vaccinated:2007-04-09
Onset:2007-04-09
   Days after vaccination:0
Submitted: 2007-04-16
   Days after onset:7
Entered: 2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1208F / 1 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2221AA / 1 LA / IM

Administered by: Private       Purchased by: Unknown
Symptoms: Blood pressure orthostatic, Dizziness, Fall, Feeling hot, Haemoglobin, Head injury, Heart rate, Posture abnormal, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (narrow), Vestibular disorders (broad), 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: Birth control "patch", Albuterol Inhaler prn
Current Illness: none
Preexisting Conditions: Asthma, Dysmenorrhea, Migraines-Acne
Allergies:
Diagnostic Lab Data: Orthostatic vital signs done; stable
CDC Split Type: NH0717

Write-up: Patient had lab work done 1st (hemoglobin), then received vaccines-Gardasil and Menactra left exam room, walked into waiting room and told mother she felt "hot and dizzy"; "fell over, hit head, eyes remained and open, head arched back, arms shaking. "Episode over within 1-2 minutes.


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