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This is VAERS ID 281574

Case Details

VAERS ID: 281574 (history)  
Age: 15.0  
Gender: Female  
Location: Florida  
Vaccinated:2007-06-13
Onset:2007-06-13
   Days after vaccination:0
Submitted: 2007-06-13
   Days after onset:0
Entered: 2007-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB114AN / 1 RA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0263U / 0 LA / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (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:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt given HPV vaccine at 11:35 at 11:40 began to give Hep A vaccine, at beginning of administration client lost consciencousness. VS were as follows BP 110/70, pulse 74 Resp 20, client awoke independantly. EMT''s had been called and responded by 11:44, benedryl 50mg given per MD order. Client recovered and she and her mother declined transport to Emergency room.


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