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This is VAERS ID 263201

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

263201
VAERS Form:
Age:
Gender:Female
Location:New York
Vaccinated:2006-08-02
Onset:2006-08-02
Submitted:2006-09-14
Entered:2006-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. - / 0 UN / -

Administered by: Other      Purchased by: Unknown
Symptoms: Syncope

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? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type':

Write-up:Information has been received from a registered nurse concerning a female who on 02-AUG-2006 was vaccinated with the first dose of HPV rLi 3 11 16 18 VLP vaccine (yeast). It was reported that the patient fainted /"shortly after receiving the vaccination/"". The nurse did not feel the experience was vaccine related and stated /"the patient was very uneasy with the idea of an injection/". The patient subsequently recovered /"shortly after fainting/". Unspecified medical attention was sought. Additional


Changed on 12/8/2009

263201 Before After
VAERS Form:
Age:
Gender:Female
Location:New York
Vaccinated:2006-08-02
Onset:2006-08-02
Submitted:2006-09-14
Entered:2006-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Syncope

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? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': (blank) WAES0608USA01129

Write-up:Information has been received from a registered nurse concerning a female who on 02-AUG-2006 was vaccinated with the first dose of HPV rLi 3 11 16 18 VLP vaccine (yeast). It was reported that the patient fainted /"shortly "shortly after receiving the vaccination/"". vaccination". The nurse did not feel the experience was vaccine related and stated /"the "the patient was very uneasy with the idea of an injection/". injection". The patient subsequently recovered /"shortly "shortly after fainting/". fainting". Unspecified medical attention was sought. Additional information has been requested.


Changed on 9/14/2017

263201 Before After
VAERS Form:(blank) 1
Age:
Gender:Female
Location:New York
Vaccinated:2006-08-02
Onset:2006-08-02
Submitted:2006-09-14
Entered:2006-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 1 UN / -

Administered by: Other      Purchased by: Other
Symptoms: Syncope

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? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0608USA01129

Write-up:Information has been received from a registered nurse concerning a female who on 02-AUG-2006 was vaccinated with the first dose of HPV rLi 3 11 16 18 VLP vaccine (yeast). It was reported that the patient fainted "shortly after receiving the vaccination". The nurse did not feel the experience was vaccine related and stated "the patient was very uneasy with the idea of an injection". The patient subsequently recovered "shortly after fainting". Unspecified medical attention was sought. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=263201&WAYBACKHISTORY=ON


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