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This is VAERS ID 282420

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

282420
VAERS Form:
Age:15.0
Gender:Female
Location:New York
Vaccinated:2007-06-15
Onset:2007-06-15
Submitted:2007-06-20
Entered:2007-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB163AB / 0 UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN

Administered by: Private      Purchased by: Unknown
Symptoms: Cyanosis, Grand mal convulsion, Urinary incontinence, Oxygen supplementation

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions: NEUROCARDIOGENIC SYNCOPE, Relevant medical history included after Septra. The subject had not experienced any adverse events following previous vaccinations.
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type':

Write-up:This case was reported by a nurse and described the occurrence of generalized tonic clonic seizures in a 15-year-old female subject who was vaccinated with Havrix, GlaxoSmithKline, Gardasil (non-gsk) for prophylaxis. The subject''''s medical history include"d neurocardiogenic syncope and hives after Septra. On 15 June 2007, the subject received 1st dose of Havrix (unknown, left arm), and unspecified dose of Gardasil (unknown). On 15 June 2007, less than one day after vaccination with Gardasil and Havrix, the


Changed on 12/8/2009

282420 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:New York
Vaccinated:2007-06-15
Onset:2007-06-15
Submitted:2007-06-20
Entered:2007-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB163AB / 0 UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN

Administered by: Private      Purchased by: Unknown Private
Symptoms: Cyanosis, Grand mal convulsion, Urinary incontinence, Oxygen supplementation

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions: NEUROCARDIOGENIC SYNCOPE, Relevant medical history included after Septra. The subject had not experienced any adverse events following previous vaccinations.
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': (blank) A0658277A

Write-up:This case was reported by a nurse and described the occurrence of generalized tonic clonic seizures in a 15-year-old female subject who was vaccinated with Havrix, GlaxoSmithKline, Gardasil (non-gsk) for prophylaxis. The subject''''s subject''s medical history include"d included neurocardiogenic syncope and hives after Septra. On 15 June 2007, the subject received 1st dose of Havrix (unknown, left arm), and unspecified dose of Gardasil (unknown). On 15 June 2007, less than one day after vaccination with Gardasil and Havrix, the subject experienced generalized tonic clonic seizures, urinary incontinence and "tonic" cyanosis. The subject experienced a seizure while sitting in the waiting room after her vaccinations were administered. This case was assessed as medically serious by GSK. The subject was treated with oxygen and went to the emergency room and was later released. At the time of reporting, her vital signs were stable and the events were resolved.


Changed on 9/14/2017

282420 Before After
VAERS Form:(blank) 1
Age:15.0
Gender:Female
Location:New York
Vaccinated:2007-06-15
Onset:2007-06-15
Submitted:2007-06-20
Entered:2007-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB163AB / 0 1 UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UNK UN / UN

Administered by: Private      Purchased by: Private
Symptoms: Cyanosis, Grand mal convulsion, Urinary incontinence, Oxygen supplementation

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions: NEUROCARDIOGENIC SYNCOPE, Relevant medical history included after Septra. The subject had not experienced any adverse events following previous vaccinations.
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': A0658277A

Write-up:This case was reported by a nurse and described the occurrence of generalized tonic clonic seizures in a 15-year-old female subject who was vaccinated with Havrix, GlaxoSmithKline, Gardasil (non-gsk) for prophylaxis. The subject''s medical history included neurocardiogenic syncope and hives after Septra. On 15 June 2007, the subject received 1st dose of Havrix (unknown, left arm), and unspecified dose of Gardasil (unknown). On 15 June 2007, less than one day after vaccination with Gardasil and Havrix, the subject experienced generalized tonic clonic seizures, urinary incontinence and "tonic" cyanosis. The subject experienced a seizure while sitting in the waiting room after her vaccinations were administered. This case was assessed as medically serious by GSK. The subject was treated with oxygen and went to the emergency room and was later released. At the time of reporting, her vital signs were stable and the events were resolved.


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