This is VAERS ID 307011
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| VAERS ID: | 307011 (history) | Vaccinated: | 2008-03-08 | | Age: | 15.0 | Onset: | 2008-03-08, Days after vaccination: 0 | | Gender: | Female | Submitted: | 2008-03-13, Days after onset: 4 | | Location: | Georga | Entered: | 2008-03-13 | |
| Life Threatening? No |
| Died? No |
| Permanent Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Previous Vaccinations: Fainting~ ()~~0~In Patient | | Other Medications: | | Current Illness: None | | Preexisting Conditions: None | | Diagnostic Lab Data: None | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HEPA: HEP A (HAVRIX) | GLAXOSMITHKLINE BIOLOGICALS | AHAVB217BA | | IM | LA | | VARCEL: VARICELLA (VARIVAX) | MERCK & CO. INC. | 1508U | 1 | IM | LA | |
| Administered by: Unknown Purchased by: Unknown | Symptoms: Pain in extremity,
Pallor,
Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
| | Write-up: Administered HPV (Gardasil) vaccine #1 in child''s left deltoid. Patient fainted. I put ammonia under her nose. She woke up but was very pale and complained of her legs hurting. She then put her head between her legs and she began to feel better. |
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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=307011
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