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This is VAERS ID 302324

(NOTE: This result is from the 12/8/2009 version of the VAERS database)

Case Details

VAERS ID: 302324 (history)  
Form: Version .0  
Age: 12.0  
Gender: Female  
Location: Pennsylvania  
Vaccinated:2007-10-30
Onset:2007-11-23
   Days after vaccination:24
Submitted: 2008-01-10
   Days after onset:48
Entered: 2008-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - LA / IM
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER GARDASIL ?? / 0 RA / UN

Administered by: Unknown       Purchased by: Unknown
Symptoms: Anxiety, Convulsion, Dizziness, Headache, Nausea, Syncope, Ultrasound abdomen, Visual disturbance
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: we were instructed to log symptoms for 1 month.when examined her regular dr. was unavailable so she was seen by a Dr.Yost, who insisted that the symptoms had no relation to the injection and stated that she probably hit her head when she fa
CDC Split Type:

Write-up: 24 days after having the flu shot and Gardasil vaccine simultaneously,experienced an episode of nausea, dizziness, severe headache, seeing black spots, fainted and seizure activity(her teacher reported that she was shaking). She continues to have frequent headaches, nausea and occassional dizziness, & anxiety over the above.


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Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20091208&IDNUMBER=302324


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