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This is VAERS ID 394854

Case Details

VAERS ID: 394854 (history)  
Age: 16.0  
Gender: Female  
Location: Indiana  
Vaccinated:2010-07-16
Onset:2010-07-16
   Days after vaccination:0
Submitted: 2010-08-10
   Days after onset:25
Entered: 2010-08-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB379AA / 0 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U3098AA / 0 LA / IM

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)

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

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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