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This is VAERS ID 394854

Case Details

VAERS ID:394854 (history)  Vaccinated:2010-07-16
Age:16.0  Onset:2010-07-16, Days after vaccination: 0
Gender:Female  Submitted:2010-08-10, Days after onset: 25
Location:Indiana  Entered:2010-08-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB379AA0IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU3098AA0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Dyspnoea, Tachycardia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)
Write-up: Patient presented to office today (8-10-10) for GARDASIL #3 and reports she had difficulty breathing and tachycardia after receiving MCV-4 and HEP A #1 on 7-16-10. States symptoms started about 30 min after shots. Went to doctor. No tx given.

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