Age: 16.0
Sex: F
Vaccine: HEPA, MENB
Symptoms: Hyperventilation, Hypoaesthesia, Hypotonia, Musculoskeletal stiffness, Pallor
Clinical narrative: Client and mother arrived this morning for vaccination and reported they had just come from the client's "weights class." Offered to answer questions about Hep A and Men B and they denied having any (we had discussed these vaccinations at a previous appointment).  This RN administered Hep A #1 to upper left deltoid. Client tolerated well. Men B #1 was then administered to left deltoid below Hep A site. Client initially reported no concerns, however, as this nurse began reviewing "after the shots" information with client and mother client reported her eyes were "getting fuzzy." She became pale and both this RN and mother grabbed client. I instructed her to lay and assisted her to the floor at which time she appeared to go limp and went unresponsive with her eyes open staring straight ahead. Mother had cell phone and dialed 911.  This RN shouted client's name and sternal rubbed her and after about 10-15 seconds client started responding, and attempted to sit herself up. 911 had just picked up and mother called off ambulance at this time. She was alert and orientated and began to cry due to being scared about the incident. Reassurance given, appeared to be perfusing well (lips pink, skin still pale but color improving). She did c/o left ankle pain initially but denied chest and abdominal pain or difficulty breathing. Cool packs were placed to back of neck, armpits and forehead. She was breathing deeply and quickly and this RN coached her to take slow deep breaths. She then c/o her hands and arms feeling "numb" as well as right thumb being "stiff." Client had +5/5 strength to bilateral hands and was able to squeeze this RN's tightly several times and move all fingers and thumbs appropriately when asked. She was able to feel touch to arms and hands. Her boots were removed and she was able to feel touch to feet and wiggle all toes appropriately. She had thick socks on but a pulse was palpable. BP 132/74. Area around eyes and eyelids were red (appeared to be from crying) but there was no swelling and child reported her vision had improved. Area around lips was also slightly reddened but again, no swelling or other abnormalities noted. No swelling of tongue or throat noted by this RN or client. Client did state she felt like her "lips and arms/hands" were "quivering." Mom was informed that child should go to local ER to be evaluated by physician, which is only a couple of blocks from facility and she was in agreement. This RN did offer to give epinephrine per facility protocol but mother declined at this time as ER is only a couple minutes away. Father was called by mother and arrived to assist in taking child to ER. She was breathing adequately and her skin color had returned to normal other than the slight redness around eyes and lips. Child was assisted to her feet and was able to stand with minimal assist although this RN and parents kept hold of her for safety. She denied dizziness or feeling like she was going to "pass out" upon standing, only reported feeling "a little weak." Father opted to carry child to pickup and this RN assisted them to the vehicle. Child was taken by parental vehicle to Emergency Room.  This RN did call and give report to ER nurse on the above incident and nurse stated they had arrived during the call at approximately 0845. Immunization Program Supervisor made aware of incident and this VAERS is completed for submission as per policy.