National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 11/26/2021 release of VAERS data:

This is VAERS ID 491885

Government Disclaimer on use of this data

Case Details

VAERS ID: 491885 (history)  
Form: Version 1.0  
Age: 11.0  
Sex: Female  
Location: Indiana  
   Days after vaccination:0
Submitted: 2013-05-17
   Days after onset:7
Entered: 2013-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Private       Purchased by: Public
Symptoms: Blood gases, Blood glucose, Cardiac monitoring, Computerised tomogram head, Dizziness, Drug screen, Electrocardiogram, Full blood count, Grip strength decreased, Headache, Incoherent, Metabolic function test, Somnolence
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Drug abuse and dependence (broad), Psychosis and psychotic disorders (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Metformin 1 tablet qd
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: CBC; CMV; CT scan head; Hospital stay x24h
CDC Split Type:

Write-up: About 5:30 pm patient c/o headache. C/O mom found patient in tub asleep about 6 pm. Patient got out of tub was in moms room bent over to pick up cup. Patient could not grab a hold of cup. C/O dizziness, talking to mom incoherently. Took to ER local. Patient was real drowsy want to sleep. ER did - EKG, blood test, B/S, Blood gases CT scan drug testing U/A. ER couldn''t find out the problem. Transfer by helicopter to hospital. Heart monitored overnight. Patient was fine the next morning.

New Search

Link To This Search Result:

Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166