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This is VAERS ID 262096

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

262096
VAERS Form:
Age:17.0
Gender:Female
Location:New York
Vaccinated:2006-08-14
Onset:2006-08-14
Submitted:2006-08-21
Entered:2006-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. 0637C / 0 RA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Asthenia, Chills, Cyanosis, Dizziness, Pallor

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:1 hr after vaccination, pt reported to feel dizzy, weak, vision went black for a few seconds, got pale with purple lips x 1/2hr. Felt better after drinking OJ. Then got temp 101F and chills x 1 day.


Changed on 12/8/2009

262096 Before After
VAERS Form:
Age:17.0
Gender:Female
Location:New York
Vaccinated:2006-08-14
Onset:2006-08-14
Submitted:2006-08-21
Entered:2006-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) HPV (GARDASIL) / MERCK & CO. INC. 0637C / 0 RA / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Asthenia, Chills, Cyanosis, Dizziness, Pallor, Pyrexia, Visual disturbance

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:1 hr after vaccination, pt reported to feel dizzy, weak, vision went black for a few seconds, got pale with purple lips x 1/2hr. Felt better after drinking OJ. Then got temp 101F and chills x 1 day.


Changed on 9/14/2017

262096 Before After
VAERS Form:(blank) 1
Age:17.0
Gender:Female
Location:New York
Vaccinated:2006-08-14
Onset:2006-08-14
Submitted:2006-08-21
Entered:2006-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637C / 0 1 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Asthenia, Chills, Cyanosis, Dizziness, Pallor, Pyrexia, Visual disturbance

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:1 hr after vaccination, pt reported to feel dizzy, weak, vision went black for a few seconds, got pale with purple lips x 1/2hr. Felt better after drinking OJ. Then got temp 101F and chills x 1 day.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=262096&WAYBACKHISTORY=ON


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