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This is VAERS ID 281913

Case Details

VAERS ID: 281913 (history)  
Form: Version 1.0  
Age: 30.0  
Gender: Female  
Location: Pennsylvania  
   Days after vaccination:0
Submitted: 2007-06-14
   Days after onset:0
Entered: 2007-06-15
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Private       Purchased by: Other
Symptoms: Asthenia, Blood glucose increased, Blood pressure decreased, Body temperature increased, Dyspnoea, Flushing, Hyperhidrosis, Inappropriate schedule of drug administration, Pallor
SMQs:, Anaphylactic reaction (narrow), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: multivitamin, fish oil capsule
Current Illness: none
Preexisting Conditions: allergic rhinitis - seasonal allergies - ragweed
Diagnostic Lab Data: Blood glucose finger stuck 115
CDC Split Type:

Write-up: Approx 15-20 seconds post injection pt stated she became flushed, diaphoretic and weak. Pt states she felt as if she could not take a deep breath. Pt temp 99 deg F. Pt feet elevated. BP 90/60, Pulse 83.Pt given orange juice and graham crackers and Tylenol 325 mg. After approx 15 min, pt verbalized she felt better. BP 110/60, pulse 83. Pt was pale, but color returned after 15 minutes. Blood Glucose 115. Pt was able to stand without difficulty and walk. Total time 20 minutes.

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