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This is VAERS ID 704488

Case Details

VAERS ID: 704488 (history)  
Form: Version 1.0  
Age: 18.0  
Gender: Female  
Location: Vermont  
   Days after vaccination:0
Submitted: 2017-07-17
   Days after onset:0
Entered: 2017-07-19
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Public
Symptoms: Altered state of consciousness, Cold sweat, Eye movement disorder, Feeling abnormal, Nausea, Pallor, Paraesthesia, Rash
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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? No
Previous Vaccinations:
Other Medications: PPD Mantoux; TUMS ULTRA; TRISPRINTEC
Current Illness: None
Preexisting Conditions: Anxiety; Allergic rhinitis; Ovarian cyst; Allergies: PCN, doxycycline, tretinoin
Diagnostic Lab Data: Pulse ox sats 98%; HR 88-110.
CDC Split Type:

Write-up: 15 min S/P BEXSERO and PPD placement, while on toilet pt C/O nausea and feeling like she was going to pass out. Pt pale and eyes started to rolled back in head. Pt alert and oriented x 3. Helped into wheelchair. Pt then reported tingling. Clammy and reported "I just don''t feel like I''m here". Noted rash on chest. (HX anxiety rash). This occurred in BR outside clinic office - 911 called and sent to ER for evaluation.

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