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This is VAERS ID 280449

Case Details

VAERS ID: 280449 (history)  
Age: 16.0  
Gender: Female  
Location: Unknown  
Vaccinated:2007-05-29
Onset:2007-05-29
   Days after vaccination:0
Submitted: 2007-06-04
   Days after onset:6
Entered: 2007-06-05
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0246U / 1 RA / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0522U / - LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2277AA / - RA / UN
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0455U / 1 LA / UN

Administered by: Private       Purchased by: Unknown
Symptoms: Blood pressure decreased, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: After few moments of receiving multiple vax and Gardasil, patient had a syncope, blood pressure dropped. She recovered. 06/06/07-records received. Vaccine record documents on 5/30/07 Gardasil lot# 0522U, Varicella Lot #0455U, Menactra lot#U2277AA, Hepatitis A 2 lot#0246U. After vaccination patien left room and had loss of consciousness for 10 seconds. BP 88/54. Felt better after resting. Walked out of office with mother


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