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This is VAERS ID 491885

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History of Changes from the VAERS Wayback Machine

First Appeared on 6/12/2013

VAERS ID: 491885
VAERS Form:
Age:11.0
Sex:Female
Location:Indiana
Vaccinated:2013-05-10
Onset:2013-05-10
Submitted:2013-05-17
Entered:2013-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA174BJ / 1 LA / IM

Administered by: Private      Purchased by: Public
Symptoms: Blood gases, Blood glucose, Dizziness, Electrocardiogram, Full blood count, Headache, Incoherent, Somnolence, Drug screen, Cardiac monitoring, Computerised tomogram head, Metabolic function test, Grip strength decreased

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Metformin 1 tablet qd
Current Illness:
Preexisting Conditions:
Allergies:
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.


Changed on 9/17/2013

VAERS ID: 491885 Before After
VAERS Form:
Age:11.0
Sex:Female
Location:Indiana
Vaccinated:2013-05-10
Onset:2013-05-10
Submitted:2013-05-17
Entered:2013-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA174BJ / 1 LA / IM

Administered by: Private      Purchased by: Public
Symptoms: Asthenia, Bladder catheterisation, Blood culture negative, Blood gases, Blood gases abnormal, Blood glucose, Chest X-ray normal, Confusional state, Culture urine negative, Dizziness, Electrocardiogram, Electrocardiogram abnormal, Full blood count, Headache, Incoherent, Lethargy, Mydriasis, Pupillary reflex impaired, Sinus bradycardia, Somnolence, Toxic encephalopathy, White blood cell count increased, Mental status changes, Drug screen, Monocyte percentage increased, Cardiac monitoring, Computerised tomogram head, Blood alkaline phosphatase increased, Toxicologic test normal, Urine analysis normal, Metabolic encephalopathy, Metabolic function test, Grip strength decreased, Human chorionic gonadotropin negative, Computerised tomogram head abnormal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Metformin 1 tablet qd
Current Illness:
Preexisting Conditions: The following information was obtained through follow-up and/or provided by the government. PMH: pre-diabetes.
Allergies:
Diagnostic Lab Data: CBC; CMV; CT scan head; Hospital stay x24h The following information was obtained through follow-up and/or provided by the government. 5/22 & 28/2013 lab/diagnostic records received for DOS 5/10/2013. CT head: midline lipoma @ quadrigeminal cistern & @ midline along corpus callosum, no acute abnormality. CXR, UA WNL. Tox screen, urine HCG, blood/urine cx (-). Blood: WBC 10.7 K/mm3 (H), monos 9.3% (H), ALP 358 U/L (H). ABGs abnormal. ECG: sinus brady.
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. The following information was obtained through follow-up and/or provided by the government. 5/22 & 28/2013 ER records received for DOS 5/10/2013. Dx: lethargy. Pt c/o headache, dizziness, confusion, became somnolent & difficult to wake. PE: lethargic, confused, dilated pupils minimally reactive to light, generalized weakness. Foley placed, pt more awake. Pt transferred for higher level care. 7/22/2013 hospital records received for DOS 5/10-11/2013. D/c Dx: 1) altered mental status; 2) toxic/metabolic encephalopathy, resolved @ d/c. Pt received w/ hx noted above. Back to baseline by arrival. Admitted for observation. D/c''d home w/ care & f/u instructions.


Changed on 3/14/2015

VAERS ID: 491885 Before After
VAERS Form:
Age:11.0
Sex:Female
Location:Indiana
Vaccinated:2013-05-10
Onset:2013-05-10
Submitted:2013-05-17
Entered:2013-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA174BJ / 1 LA / IM

Administered by: Private      Purchased by: Public
Symptoms: Asthenia, Bladder catheterisation, Blood culture negative, Blood gases, Blood gases abnormal, Blood glucose, Chest X-ray normal, Confusional state, Culture urine negative, Dizziness, Electrocardiogram, Electrocardiogram abnormal, Full blood count, Headache, Incoherent, Lethargy, Mydriasis, Pupillary reflex impaired, Sinus bradycardia, Somnolence, Toxic encephalopathy, White blood cell count increased, Mental status changes, Drug screen, Monocyte percentage increased, Cardiac monitoring, Computerised tomogram head, Blood alkaline phosphatase increased, Toxicologic test normal, Urine analysis normal, Metabolic encephalopathy, Metabolic function test, Grip strength decreased, Human chorionic gonadotropin negative, Computerised tomogram head abnormal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Metformin 1 tablet qd
Current Illness:
Preexisting Conditions: The following information was obtained through follow-up and/or provided by the government. PMH: pre-diabetes.
Allergies:
Diagnostic Lab Data: CBC; CMV; CT scan head; Hospital stay x24h The following information was obtained through follow-up and/or provided by the government. 5/22 & 28/2013 lab/diagnostic records received for DOS 5/10/2013. CT head: midline lipoma @ quadrigeminal cistern & @ midline along corpus callosum, no acute abnormality. CXR, UA WNL. Tox screen, urine HCG, blood/urine cx (-). Blood: WBC 10.7 K/mm3 (H), monos 9.3% (H), ALP 358 U/L (H). ABGs abnormal. ECG: sinus brady.
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. The following information was obtained through follow-up and/or provided by the government. 5/22 & 28/2013 ER records received for DOS 5/10/2013. Dx: lethargy. Pt c/o headache, dizziness, confusion, became somnolent & difficult to wake. PE: lethargic, confused, dilated pupils minimally reactive to light, generalized weakness. Foley placed, pt more awake. Pt transferred for higher level care. 7/22/2013 hospital records received for DOS 5/10-11/2013. D/c Dx: 1) altered mental status; 2) toxic/metabolic encephalopathy, resolved @ d/c. Pt received w/ hx noted above. Back to baseline by arrival. Admitted for observation. D/c''d home w/ care & f/u instructions.


Changed on 9/14/2017

VAERS ID: 491885 Before After
VAERS Form:(blank) 1
Age:11.0
Sex:Female
Location:Indiana
Vaccinated:2013-05-10
Onset:2013-05-10
Submitted:2013-05-17
Entered:2013-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA174BJ / 1 2 LA / IM

Administered by: Private      Purchased by: Public
Symptoms: Blood gases, Blood glucose, Dizziness, Electrocardiogram, Full blood count, Headache, Incoherent, Somnolence, Drug screen, Cardiac monitoring, Computerised tomogram head, Metabolic function test, Grip strength decreased

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Metformin 1 tablet qd
Current Illness:
Preexisting Conditions:
Allergies:
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.


Changed on 2/14/2018

VAERS ID: 491885 Before After
VAERS Form:1
Age:11.0
Sex:Female
Location:Indiana
Vaccinated:2013-05-10
Onset:2013-05-10
Submitted:2013-05-17
Entered:2013-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA174BJ / 2 LA / IM

Administered by: Private      Purchased by: Public
Symptoms: Blood gases, Blood glucose, Dizziness, Electrocardiogram, Full blood count, Headache, Incoherent, Somnolence, Drug screen, Cardiac monitoring, Computerised tomogram head, Metabolic function test, Grip strength decreased

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Metformin 1 tablet qd
Current Illness:
Preexisting Conditions:
Allergies:
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.


Changed on 6/14/2018

VAERS ID: 491885 Before After
VAERS Form:1
Age:11.0
Sex:Female
Location:Indiana
Vaccinated:2013-05-10
Onset:2013-05-10
Submitted:2013-05-17
Entered:2013-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA174BJ / 2 LA / IM

Administered by: Private      Purchased by: Public
Symptoms: Blood gases, Blood glucose, Dizziness, Electrocardiogram, Full blood count, Headache, Incoherent, Somnolence, Drug screen, Cardiac monitoring, Computerised tomogram head, Metabolic function test, Grip strength decreased

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Metformin 1 tablet qd
Current Illness:
Preexisting Conditions:
Allergies:
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.


Changed on 8/14/2018

VAERS ID: 491885 Before After
VAERS Form:1
Age:11.0
Sex:Female
Location:Indiana
Vaccinated:2013-05-10
Onset:2013-05-10
Submitted:2013-05-17
Entered:2013-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA174BJ / 2 LA / IM

Administered by: Private      Purchased by: Public
Symptoms: Blood gases, Blood glucose, Dizziness, Electrocardiogram, Full blood count, Headache, Incoherent, Somnolence, Drug screen, Cardiac monitoring, Computerised tomogram head, Metabolic function test, Grip strength decreased

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Metformin 1 tablet qd
Current Illness:
Preexisting Conditions:
Allergies:
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.


Changed on 9/14/2018

VAERS ID: 491885 Before After
VAERS Form:1
Age:11.0
Sex:Female
Location:Indiana
Vaccinated:2013-05-10
Onset:2013-05-10
Submitted:2013-05-17
Entered:2013-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA174BJ / 2 LA / IM

Administered by: Private      Purchased by: Public
Symptoms: Blood gases, Blood glucose, Dizziness, Electrocardiogram, Full blood count, Headache, Incoherent, Somnolence, Drug screen, Cardiac monitoring, Computerised tomogram head, Metabolic function test, Grip strength decreased

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Metformin 1 tablet qd
Current Illness:
Preexisting Conditions:
Allergies:
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.


Changed on 10/14/2018

VAERS ID: 491885 Before After
VAERS Form:1
Age:11.0
Sex:Female
Location:Indiana
Vaccinated:2013-05-10
Onset:2013-05-10
Submitted:2013-05-17
Entered:2013-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA174BJ / 2 LA / IM

Administered by: Private      Purchased by: Public
Symptoms: Blood gases, Blood glucose, Dizziness, Electrocardiogram, Full blood count, Headache, Incoherent, Somnolence, Drug screen, Cardiac monitoring, Computerised tomogram head, Metabolic function test, Grip strength decreased

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Metformin 1 tablet qd
Current Illness:
Preexisting Conditions:
Allergies:
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.


Changed on 12/24/2020

VAERS ID: 491885 Before After
VAERS Form:1
Age:11.0
Sex:Female
Location:Indiana
Vaccinated:2013-05-10
Onset:2013-05-10
Submitted:2013-05-17
Entered:2013-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA174BJ / 2 LA / IM

Administered by: Private      Purchased by: Public
Symptoms: Blood gases, Blood glucose, Dizziness, Electrocardiogram, Full blood count, Headache, Incoherent, Somnolence, Drug screen, Cardiac monitoring, Computerised tomogram head, Metabolic function test, Grip strength decreased

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Metformin 1 tablet qd
Current Illness:
Preexisting Conditions:
Allergies:
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.


Changed on 12/30/2020

VAERS ID: 491885 Before After
VAERS Form:1
Age:11.0
Sex:Female
Location:Indiana
Vaccinated:2013-05-10
Onset:2013-05-10
Submitted:2013-05-17
Entered:2013-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA174BJ / 2 LA / IM

Administered by: Private      Purchased by: Public
Symptoms: Blood gases, Blood glucose, Dizziness, Electrocardiogram, Full blood count, Headache, Incoherent, Somnolence, Drug screen, Cardiac monitoring, Computerised tomogram head, Metabolic function test, Grip strength decreased

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Metformin 1 tablet qd
Current Illness:
Preexisting Conditions:
Allergies:
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.


Changed on 5/7/2021

VAERS ID: 491885 Before After
VAERS Form:1
Age:11.0
Sex:Female
Location:Indiana
Vaccinated:2013-05-10
Onset:2013-05-10
Submitted:2013-05-17
Entered:2013-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA174BJ / 2 LA / IM

Administered by: Private      Purchased by: Public
Symptoms: Blood gases, Blood glucose, Dizziness, Electrocardiogram, Full blood count, Headache, Incoherent, Somnolence, Drug screen, Cardiac monitoring, Computerised tomogram head, Metabolic function test, Grip strength decreased

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Metformin 1 tablet qd
Current Illness:
Preexisting Conditions:
Allergies:
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.


Changed on 5/21/2021

VAERS ID: 491885 Before After
VAERS Form:1
Age:11.0
Sex:Female
Location:Indiana
Vaccinated:2013-05-10
Onset:2013-05-10
Submitted:2013-05-17
Entered:2013-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA174BJ / 2 LA / IM

Administered by: Private      Purchased by: Public
Symptoms: Blood gases, Blood glucose, Dizziness, Electrocardiogram, Full blood count, Headache, Incoherent, Somnolence, Drug screen, Cardiac monitoring, Computerised tomogram head, Metabolic function test, Grip strength decreased

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Metformin 1 tablet qd
Current Illness:
Preexisting Conditions:
Allergies:
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.

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