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This is VAERS ID 283857

Case Details

VAERS ID: 283857 (history)  
Form: Version 1.0  
Age: 15.0  
Gender: Female  
Location: Massachusetts  
Vaccinated:2007-06-29
Onset:2007-06-29
   Days after vaccination:0
Submitted: 2007-07-02
   Days after onset:3
Entered: 2007-07-05
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0524V / 1 RA / -
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2720 / 1 LA / -

Administered by: Private       Purchased by: Private
Symptoms: Hyperhidrosis, Pallor
SMQs:, Neuroleptic malignant syndrome (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt became pale, diaphoretic, after vaccine administered was given, sitting down, had not eaten all day BP 102/68 - 112/80 O2 98-100%.


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