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This is VAERS ID 282413

Case Details

VAERS ID: 282413 (history)  
Age: 13.0  
Gender: Female  
Location: Michigan  
Vaccinated:2007-04-17
Onset:2007-04-18
   Days after vaccination:1
Submitted: 2007-06-20
   Days after onset:63
Entered: 2007-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1208F / 0 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2139AA / 0 RA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2638AA / 0 LA / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Asthenia, Coordination abnormal, Dizziness, Rash generalised, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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: Vaccines administered evening of 4/17/07, client did not have any adverse effect until next day. States while in school started feeling weak and dizzy, this progressivly became worse, but did not require leaving school. That night symptoms still occuring and worsening. "almost drunk -like" Mother callled ER at Hospital. Instruced to give Benadryl. Client Slept through night. Remained "dizzy and uncoordinated: the next morning, received more Benadryl. Symptoms resolved that day. No rash during initial episode, but did C/O rash over majority of body, possibly hives, about 2 weeks after immunizations. Benadryl given about TID during this episode and rash lasted about 3 days.No further symptoms. Informed of these events on 6/19/07 when client came in for HPV #2, incident reviewed by Medical director and order obtained to give HPV #2, request that family call Health Department for any problems.


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