National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 277309

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 277309
Age:13.0
Gender:Female
Location:Pennsylvania
Vaccinated:2007-04-11
Onset:2007-04-11
Submitted:2007-04-12
Entered:2007-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM AHAVB148AA / 1 RA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0263U / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR U1908AA / 0 RA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1148F / 1 LA / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Blood pressure normal, Dizziness, Hypotonia, Loss of consciousness, Muscle rigidity

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: O2 Sat 98%, BP 102/78
CDC 'Split Type':

Write-up:After vaccine was given pt stated /"she felt like she was going to pass out/" she turned pale and rigid and lost conscious for about 1 min and when she came to she had post ictal s/s of a blank stare for about 5-10 sec and no response. Pt did walk back to"a room without much time, when she got back to the room she became /"limp/" and needed to be lifted onto a tablet. Went home A+o x ''''53


Changed on 12/8/2009

VAERS ID: 277309 Before After
Age:13.0
Gender:Female
Location:Pennsylvania
Vaccinated:2007-04-11
Onset:2007-04-11
Submitted:2007-04-12
Entered:2007-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM AHAVB148AA / 1 RA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0263U / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR U1908AA / 0 RA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1148F / 1 LA / SC

Administered by: Private      Purchased by: Unknown Private
Symptoms: Blood pressure normal, Dizziness, Hypotonia, Loss of consciousness, Muscle rigidity, Oxygen saturation normal, Pallor, Staring, Postictal state

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: O2 Sat 98%, BP 102/78
CDC 'Split Type':

Write-up:After vaccine was given pt stated /"she "she felt like she was going to pass out/" out" she turned pale and rigid and lost conscious for about 1 min and when she came to she had post ictal s/s of a blank stare for about 5-10 sec and no response. Pt did walk back to"a to a room without much time, when she got back to the room she became /"limp/" "limp" and needed to be lifted onto a tablet. Went home A+o x ''''53 ''53


Changed on 4/7/2010

VAERS ID: 277309 Before After
Age:13.0
Gender:Female
Location:Pennsylvania
Vaccinated:2007-04-11
Onset:2007-04-11
Submitted:2007-04-12
Entered:2007-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM AHAVB148AA / 1 RA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0263U / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR U1908AA / 0 RA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1148F / 1 LA / SC

Administered by: Private      Purchased by: Private
Symptoms: Blood pressure normal, Dizziness, Hypotonia, Loss of consciousness, Muscle rigidity, Oxygen saturation normal, Pallor, Staring, Postictal state

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: O2 Sat 98%, BP 102/78
CDC 'Split Type':

Write-up:After vaccine was given pt stated "she felt like she was going to pass out" she turned pale and rigid and lost conscious for about 1 min and when she came to she had post ictal s/s of a blank stare for about 5-10 sec and no response. Pt did walk back to a room without much time, when she got back to the room she became "limp" and needed to be lifted onto a tablet. Went home A+o x ''53


Changed on 5/14/2017

VAERS ID: 277309 Before After
Age:13.0
Gender:Female
Location:Pennsylvania
Vaccinated:2007-04-11
Onset:2007-04-11
Submitted:2007-04-12
Entered:2007-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM AHAVB148AA / 1 RA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0263U / 0 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR SANOFI PASTEUR U1908AA / 0 RA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1148F / 1 LA / SC

Administered by: Private      Purchased by: Private
Symptoms: Blood pressure normal, Dizziness, Hypotonia, Loss of consciousness, Muscle rigidity, Oxygen saturation normal, Pallor, Staring, Postictal state

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: O2 Sat 98%, BP 102/78
CDC 'Split Type':

Write-up:After vaccine was given pt stated "she felt like she was going to pass out" she turned pale and rigid and lost conscious for about 1 min and when she came to she had post ictal s/s of a blank stare for about 5-10 sec and no response. Pt did walk back to a room without much time, when she got back to the room she became "limp" and needed to be lifted onto a tablet. Went home A+o x ''53


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=277309&WAYBACKHISTORY=ON


Copyright © 2017 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166