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This is VAERS ID 281699

Case Details

VAERS ID: 281699 (history)  
Age:   
Gender: Female  
Location: Arizona  
Vaccinated:2007-06-14
Onset:2007-06-14
   Days after vaccination:0
Submitted: 2007-06-14
   Days after onset:0
Entered: 2007-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB149AA / 0 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 0 RA / IM

Administered by: Military       Purchased by: Military
Symptoms: Cold sweat, Convulsion, Hypotonia, Loss of consciousness, Pallor
SMQs:, Torsade de pointes/QT prolongation (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (narrow), Generalised convulsive seizures following immunisation (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: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt was given two shots and immediately after administered patient became pale, limp and clammy. Patient passed out and began to have seizure activity for a few seconds. Pt regained consciousness and her vital signs were taken and were within normal range.


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