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This is VAERS ID 314847

Case Details

VAERS ID: 314847 (history)  
Age: 9.0  
Gender: Female  
Location: Unknown  
Vaccinated:2007-08-29
Onset:2007-08-29
   Days after vaccination:0
Submitted: 2008-05-16
   Days after onset:261
Entered: 2008-05-23
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 658413/1025U / - UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Immediate post-injection reaction, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (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), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type: WAES0708USA05426

Write-up: Information has been received from a health professional concerning a 9 year old female with no pertinent medical history, drug reactions or allergies who on 29-AUG-2007 was vaccinated with a "booster shot" of varicella virus vaccine live (Oka/Merck) (Lot # 658413/1025U). Concomitant therapy included human papillomavirus vaccine (GARDASIL). On 29-AUG-2007 the patient passed out immediately after receiving varicella virus vaccine live (Oka/Merck). There were no lab diagnostic studies performed. Unspecified medical attention was sought. There was no product quality complaint. Additional information has been requested.


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