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This is VAERS ID 284418

Case Details

VAERS ID: 284418 (history)  
Form: Version 1.0  
Age: 19.0  
Gender: Female  
Location: Georgia  
   Days after vaccination:0
Submitted: 2007-07-12
   Days after onset:0
Entered: 2007-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Private       Purchased by: Private
Symptoms: Blood pressure decreased, Cold compress therapy, Cold sweat, Heart rate, Pallor, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (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: Yaz
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt. given vaccine, was in the process of checking out and became fainty, clammy, poor skin color, would not acknowldege questions asked or instructions. BP at that time was 70/40, with a pulse of 50. Cold compresses applied to forehead, fan was turned to pt.,coke and saltines to pt. BP 10 minutes later was 86/58 , pulse 74. Pt. continued to rest and vitals again taken after 10 minutes-BP 90/60 and pulse 74. Pt. was no longer clammy, was speaking when spoken to, color good.Stated that she had not eaten anything this am. Felt better and was told to call the office prn.

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