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This is VAERS ID 265955

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

265955
VAERS Form:
Age:13.0
Gender:Female
Location:California
Vaccinated:2006-10-21
Onset:2006-10-21
Submitted:0000-00-00
Entered:2006-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. - / - UN / -
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / 1 RA / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Hypoaesthesia, Injection site pain, 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)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Per pt arm where Gardasil was administered felt painful then numb and then pt fainted for a few seconds.


Changed on 12/8/2009

265955 Before After
VAERS Form:
Age:13.0
Gender:Female
Location:California
Vaccinated:2006-10-21
Onset:2006-10-21
Submitted:0000-00-00
Entered:2006-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) HPV (GARDASIL) / MERCK & CO. INC. - / - UN / -
VARCEL: VARICELLA (VARIVAX) VARICELLA (VARIVAX) / MERCK & CO. INC. - / 1 RA / SC

Administered by: Private      Purchased by: Unknown Private
Symptoms: Hypoaesthesia, Injection site pain, 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)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Per pt arm where Gardasil was administered felt painful then numb and then pt fainted for a few seconds.


Changed on 9/14/2017

265955 Before After
VAERS Form:(blank) 1
Age:13.0
Gender:Female
Location:California
Vaccinated:2006-10-21
Onset:2006-10-21
Submitted:0000-00-00
Entered:2006-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UNK UN / -
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / 1 2 RA / SC

Administered by: Private      Purchased by: Private
Symptoms: Hypoaesthesia, Injection site pain, 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)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Per pt arm where Gardasil was administered felt painful then numb and then pt fainted for a few seconds.


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