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This is VAERS ID 302119

Case Details

VAERS ID:302119 (history)  Vaccinated:2008-01-03
Age:14.0  Onset:2008-01-03, Days after vaccination: 0
Gender:Female  Submitted:2008-01-09, Days after onset: 6
Location:Texas  Entered:2008-01-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No illness present at time of vaccination.
Preexisting Conditions: Anxiety (takes the listed medications for this)
Diagnostic Lab Data: **Gardasil was also given but #13 on the form does not offer it as a choice. It was the first dose of the vaccine.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0  
TDAP: TDAP (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dizziness, Loss of consciousness, Malaise, Nausea, Panic attack
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: Patient received a Tdap vaccine and a Gardasil vaccine on 1/3/08. She passed out from the vaccines. She has had no trouble with vaccines or shots in the past, including her last Tdap. She became very dizzy, and then passed out about 5-10 minutes after receiving the vaccines. She also was nauseated and didn''t feel well for several days. In addition, she takes medicines for panic disorder and the condition has been well controlled. After the vaccines, she experienced severe panic attacks for several days and required an additional anxiety medicine. She had a follow-up visit with her pediatrician and her psychiatrist to evaluate her symptoms.

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