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This is VAERS ID 662875

Case Details

VAERS ID: 662875 (history)  
Age: 12.0  
Gender: Female  
Location: Ohio  
Vaccinated:2007-01-22
Onset:2007-01-22
   Days after vaccination:0
Submitted: 2016-10-31
   Days after onset:3569
Entered: 2016-10-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U22206A / - RA / IM
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB143BA / 0 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0961F / 0 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1922AB / 0 LA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B01HH / - RL / IM

Administered by: Private       Purchased by: Private
Symptoms: Blood test, Dizziness, Hypoaesthesia, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)

Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Steroid inhaler; NEXIUM; IMITREX; ZOFRAN
Current Illness: yes, we were in for a sick visit.
Preexisting Conditions: Acid Reflux, Hiatal Hernia, migraines
Diagnostic Lab Data: At this time Blood tests, and multiple dr''s. visits and communications with dr. and ER visits.
CDC Split Type:

Write-up: Dizziness, vomiting, numbness of extremities.


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