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History of Changes from the VAERS Wayback Machine |
VAERS ID: | 264768 |
VAERS Form: | |
Age: | 15.0 |
Sex: | Female |
Location: | Maryland |
Vaccinated: | 0000-00-00 |
Onset: | 0000-00-00 |
Submitted: | 2006-10-13 |
Entered: | 2006-10-17 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. | - / - | - / - |
Administered by: Other Purchased by: Unknown
Symptoms: Pain
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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type':
Write-up: Information has been received from a certified medical assistant concerning a female patient between the age of 15 to 18 who was vaccinated with a dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). Subsequently, the patient complained of stinging. It was not"ed that the stinging was only for a moment and resolved quickly. The reporter felt that the stinging could be from the vaccine being cold. No other problems were noted with the administration. Unspecified medical attention was sought. No product quality c
Vaccinated: | 0000-00-00 |
Onset: | 0000-00-00 |
Submitted: | 2006-10-13 |
Entered: | 2006-10-17 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) HPV (GARDASIL) / MERCK & CO. INC. | - / - | - / - |
Administered by: Other Purchased by: Unknown Other
Symptoms: Pain
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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': (blank) WAES0609USA07370
Write-up: Information has been received from a certified medical assistant concerning a female patient between the age of 15 to 18 who was vaccinated with a dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). Subsequently, the patient complained of stinging. It was not"ed noted that the stinging was only for a moment and resolved quickly. The reporter felt that the stinging could be from the vaccine being cold. No other problems were noted with the administration. Unspecified medical attention was sought. No product quality c complaint was involved. Additional information has been requested.
Vaccinated: | 0000-00-00 |
Onset: | 0000-00-00 |
Submitted: | 2006-10-13 |
Entered: | 2006-10-17 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | - / - | - / - |
Administered by: Other Purchased by: Other
Symptoms: Pain
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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0609USA07370
Write-up: Information has been received from a certified medical assistant concerning a female patient between the age of 15 to 18 who was vaccinated with a dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). (yeast) (lot # 658556/1060U). Subsequently, the patient complained of stinging. It was noted that the stinging was only for a moment and resolved quickly. The reporter felt that the stinging could be from the vaccine being cold. No other problems were noted with cold.Approximately 10 minutes post vaccination, the administration. patient got pale, lightheaded and passed out. Unspecified medical attention was sought. It was reported that the patient rested and a neurological check was performed. No product quality complaint was involved. Additional information has been requested.
Vaccinated: | 0000-00-00 |
Onset: | 0000-00-00 |
Submitted: | 2006-10-13 |
Entered: | 2006-10-17 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | - / - | - / - |
Administered by: Other Purchased by: Other
Symptoms: Dizziness, Loss of consciousness, Pain, Pallor, Neurological examination
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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0609USA07370
Write-up: Information has been received from a certified medical assistant concerning a female patient between the age of 15 to 18 who was vaccinated with a dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) (lot # 658556/1060U). Subsequently, the patient complained of stinging. It was noted that the stinging was only for a moment and resolved quickly. The reporter felt that the stinging could be from the vaccine being cold.Approximately 10 minutes post vaccination, the patient got pale, lightheaded and passed out. Unspecified medical attention was sought. It was reported that the patient rested and a neurological check was performed. No product quality complaint was involved. Additional information has been requested.
Vaccinated: | 0000-00-00 |
Onset: | 0000-00-00 |
Submitted: | 2006-10-13 |
Entered: | 2006-10-17 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | - / - | - UN / - UN |
Administered by: Other Purchased by: Other
Symptoms: Dizziness, Loss of consciousness, Pain, Pallor, Neurological examination
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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0609USA07370
Write-up: Information has been received from a certified medical assistant concerning a female patient between the age of 15 to 18 who was vaccinated with a dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) (lot # 658556/1060U). Subsequently, the patient complained of stinging. It was noted that the stinging was only for a moment and resolved quickly. The reporter felt that the stinging could be from the vaccine being cold.Approximately 10 minutes post vaccination, the patient got pale, lightheaded and passed out. Unspecified medical attention was sought. It was reported that the patient rested and a neurological check was performed. No product quality complaint was involved. Additional information has been requested.
Vaccinated: | 0000-00-00 |
Onset: | 0000-00-00 |
Submitted: | 2006-10-13 |
Entered: | 2006-10-17 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | - / - | UN / UN |
Administered by: Other Purchased by: Other
Symptoms: Dizziness, Loss of consciousness, Pain, Pallor, Neurological examination
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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0609USA07370
Write-up: Information has been received from a certified medical assistant concerning a female patient between the age of 15 to 18 who was vaccinated with a dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) (lot # 658556/1060U). Subsequently, the patient complained of stinging. It was noted that the stinging was only for a moment and resolved quickly. The reporter felt that the stinging could be from the vaccine being cold.Approximately 10 minutes post vaccination, the patient got pale, lightheaded and passed out. Unspecified medical attention was sought. It was reported that the patient rested and a neurological check was performed. No product quality complaint was involved. Additional information has been requested.
Vaccinated: | 0000-00-00 |
Onset: | 0000-00-00 |
Submitted: | 2006-10-13 |
Entered: | 2006-10-17 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | - / - | UN / UN |
Administered by: Other Purchased by: Other
Symptoms: Dizziness, Loss of consciousness, Pain, Pallor, Neurological examination
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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0609USA07370
Write-up: Information has been received from a certified medical assistant concerning a female patient between the age of 15 to 18 who was vaccinated with a dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) (lot # 658556/1060U). Subsequently, the patient complained of stinging. It was noted that the stinging was only for a moment and resolved quickly. The reporter felt that the stinging could be from the vaccine being cold.Approximately 10 minutes post vaccination, the patient got pale, lightheaded and passed out. Unspecified medical attention was sought. It was reported that the patient rested and a neurological check was performed. No product quality complaint was involved. Additional information has been requested.
Vaccinated: | 0000-00-00 |
Onset: | 0000-00-00 |
Submitted: | 2006-10-13 |
Entered: | 2006-10-17 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | - / - UNK | UN / UN |
Administered by: Other Purchased by: Other
Symptoms: Dizziness, Loss of consciousness, Pain, Pallor, Neurological examination
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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0609USA07370
Write-up: Information has been received from a certified medical assistant concerning a female patient between the age of 15 to 18 who was vaccinated with a dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) (lot # 658556/1060U). Subsequently, the patient complained of stinging. It was noted that the stinging was only for a moment and resolved quickly. The reporter felt that the stinging could be from the vaccine being cold.Approximately 10 minutes post vaccination, the patient got pale, lightheaded and passed out. Unspecified medical attention was sought. It was reported that the patient rested and a neurological check was performed. No product quality complaint was involved. Additional information has been requested.
Vaccinated: | 0000-00-00 |
Onset: | 0000-00-00 |
Submitted: | 2006-10-13 |
Entered: | 2006-10-17 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | - / UNK | UN / UN |
Administered by: Other Purchased by: Other
Symptoms: Dizziness, Loss of consciousness, Pain, Pallor, Neurological examination
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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0609USA07370
Write-up: Information has been received from a certified medical assistant concerning a female patient between the age of 15 to 18 who was vaccinated with a dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) (lot # 658556/1060U). Subsequently, the patient complained of stinging. It was noted that the stinging was only for a moment and resolved quickly. The reporter felt that the stinging could be from the vaccine being cold.Approximately 10 minutes post vaccination, the patient got pale, lightheaded and passed out. Unspecified medical attention was sought. It was reported that the patient rested and a neurological check was performed. No product quality complaint was involved. Additional information has been requested.
Vaccinated: | 0000-00-00 |
Onset: | 0000-00-00 |
Submitted: | 2006-10-13 |
Entered: | 2006-10-17 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | - / UNK | UN / UN |
Administered by: Other Purchased by: Other
Symptoms: Dizziness, Loss of consciousness, Pain, Pallor, Neurological examination
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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0609USA07370
Write-up: Information has been received from a certified medical assistant concerning a female patient between the age of 15 to 18 who was vaccinated with a dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) (lot # 658556/1060U). Subsequently, the patient complained of stinging. It was noted that the stinging was only for a moment and resolved quickly. The reporter felt that the stinging could be from the vaccine being cold.Approximately 10 minutes post vaccination, the patient got pale, lightheaded and passed out. Unspecified medical attention was sought. It was reported that the patient rested and a neurological check was performed. No product quality complaint was involved. Additional information has been requested.
Vaccinated: | 0000-00-00 |
Onset: | 0000-00-00 |
Submitted: | 2006-10-13 |
Entered: | 2006-10-17 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | - / UNK | UN / UN |
Administered by: Other Purchased by: Other
Symptoms: Dizziness, Loss of consciousness, Pain, Pallor, Neurological examination
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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0609USA07370
Write-up: Information has been received from a certified medical assistant concerning a female patient between the age of 15 to 18 who was vaccinated with a dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) (lot # 658556/1060U). Subsequently, the patient complained of stinging. It was noted that the stinging was only for a moment and resolved quickly. The reporter felt that the stinging could be from the vaccine being cold.Approximately 10 minutes post vaccination, the patient got pale, lightheaded and passed out. Unspecified medical attention was sought. It was reported that the patient rested and a neurological check was performed. No product quality complaint was involved. Additional information has been requested.
Vaccinated: | 0000-00-00 |
Onset: | 0000-00-00 |
Submitted: | 2006-10-13 |
Entered: | 2006-10-17 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | - / UNK | UN / UN |
Administered by: Other Purchased by: Other
Symptoms: Dizziness, Loss of consciousness, Pain, Pallor, Neurological examination
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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0609USA07370
Write-up: Information has been received from a certified medical assistant concerning a female patient between the age of 15 to 18 who was vaccinated with a dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) (lot # 658556/1060U). Subsequently, the patient complained of stinging. It was noted that the stinging was only for a moment and resolved quickly. The reporter felt that the stinging could be from the vaccine being cold.Approximately 10 minutes post vaccination, the patient got pale, lightheaded and passed out. Unspecified medical attention was sought. It was reported that the patient rested and a neurological check was performed. No product quality complaint was involved. Additional information has been requested.
Vaccinated: | 0000-00-00 |
Onset: | 0000-00-00 |
Submitted: | 2006-10-13 |
Entered: | 2006-10-17 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | - / UNK | UN / UN |
Administered by: Other Purchased by: Other
Symptoms: Dizziness, Loss of consciousness, Pain, Pallor, Neurological examination
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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0609USA07370
Write-up: Information has been received from a certified medical assistant concerning a female patient between the age of 15 to 18 who was vaccinated with a dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) (lot # 658556/1060U). Subsequently, the patient complained of stinging. It was noted that the stinging was only for a moment and resolved quickly. The reporter felt that the stinging could be from the vaccine being cold.Approximately 10 minutes post vaccination, the patient got pale, lightheaded and passed out. Unspecified medical attention was sought. It was reported that the patient rested and a neurological check was performed. No product quality complaint was involved. Additional information has been requested.
Vaccinated: | 0000-00-00 |
Onset: | 0000-00-00 |
Submitted: | 2006-10-13 |
Entered: | 2006-10-17 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | - / UNK | UN / UN |
Administered by: Other Purchased by: Other
Symptoms: Dizziness, Loss of consciousness, Pain, Pallor, Neurological examination
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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0609USA07370
Write-up: Information has been received from a certified medical assistant concerning a female patient between the age of 15 to 18 who was vaccinated with a dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) (lot # 658556/1060U). Subsequently, the patient complained of stinging. It was noted that the stinging was only for a moment and resolved quickly. The reporter felt that the stinging could be from the vaccine being cold.Approximately 10 minutes post vaccination, the patient got pale, lightheaded and passed out. Unspecified medical attention was sought. It was reported that the patient rested and a neurological check was performed. No product quality complaint was involved. Additional information has been requested.
Vaccinated: | 0000-00-00 |
Onset: | 0000-00-00 |
Submitted: | 2006-10-13 |
Entered: | 2006-10-17 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | - / UNK | UN / UN |
Administered by: Other Purchased by: Other
Symptoms: Dizziness, Loss of consciousness, Pain, Pallor, Neurological examination
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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0609USA07370
Write-up: Information has been received from a certified medical assistant concerning a female patient between the age of 15 to 18 who was vaccinated with a dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) (lot # 658556/1060U). Subsequently, the patient complained of stinging. It was noted that the stinging was only for a moment and resolved quickly. The reporter felt that the stinging could be from the vaccine being cold.Approximately 10 minutes post vaccination, the patient got pale, lightheaded and passed out. Unspecified medical attention was sought. It was reported that the patient rested and a neurological check was performed. No product quality complaint was involved. Additional information has been requested.
Link To This Search Result:
https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=264768&WAYBACKHISTORY=ON
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