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This is VAERS ID 280486

Case Details

VAERS ID: 280486 (history)  
Age: 21.0  
Gender: Female  
Location: Tennessee  
Vaccinated:2007-06-05
Onset:2007-06-05
   Days after vaccination:0
Submitted: 2007-06-05
   Days after onset:0
Entered: 2007-06-06
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB11BAB / 1 RA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0212U / 0 LA / IM
TD: TD ADSORBED (NO BRAND NAME) / SANOFI PASTEUR U1953AA / 1 RA / IM

Administered by: Private       Purchased by: Private
Symptoms: Immediate post-injection reaction, Nausea, Presyncope
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), 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:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 1. (L) arm Hep A then Td 2. (L) arm Gardasil Immediate onset of nausea and pre syncopal symptoms, BP 80/60 Improved within 10 min lying down


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