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This is VAERS ID 284865

Case Details

VAERS ID: 284865 (history)  
Age: 11.0  
Gender: Female  
Location: Pennsylvania  
Vaccinated:2007-07-02
Onset:2007-07-02
   Days after vaccination:0
Submitted: 2007-07-06
   Days after onset:4
Entered: 2007-07-17
   Days after submission:11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0525U / 1 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0716U / 1 RA / SC

Administered by: Private       Purchased by: Private
Symptoms: Dizziness, Hyperhidrosis, Pallor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (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: None
Preexisting Conditions: Amoxicillin allergy
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Pt appeared very pale and diaphoretic "feel like I''m going to pass out"-occurred 10 min after injection. VSS. Rested on side x 15 min and observed for total of 30 min.


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