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This is VAERS ID 283107

Case Details

VAERS ID: 283107 (history)  
Age: 12.0  
Gender: Female  
Location: Maryland  
Vaccinated:2007-06-25
Onset:2007-06-25
   Days after vaccination:0
Submitted: 2007-06-28
   Days after onset:3
Entered: 2007-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB110AA / 0 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0962F / 0 LA / IM

Administered by: Private       Purchased by: Public
Symptoms: Fatigue, Flushing, Hyperhidrosis, Nausea, Paraesthesia, Visual acuity reduced, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Hypersensitivity (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: child received Havrix Im in left deltoid, and then was given Gardasil .5ml IM. Immediately after Gardasil, pt experienced arm tingling, followed by flushing, diaphoresis, "Couldn''t see", nausea and emesis x1. Symptoms resolved within < 5 minutes and left office feeling "perfectly fine" No treatment necessary. Felt tired the following day but otherwise no residual symptoms, nor any vaccine site localized rash/swelling.


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