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This is VAERS ID 266497

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

266497
VAERS Form:
Age:17.0
Gender:Female
Location:Indiana
Vaccinated:2006-10-30
Onset:2006-10-30
Submitted:2006-11-10
Entered:2006-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. - / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Disorientation, Dizziness, Dyspnoea, Nausea, Syncope

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Advil, Benadryl, Tylenol
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Patient fainted in waiting area less than five minutes after receiving Gardasil injection. Patient disoriented and c/o difficulty breathing when roused. C/O nausea, dizziness. Sent to ER & diagnosed as vasovagal syncope. Patient c/o sores in genital area"3 days post vaccination. Upon visit to doctor, diagnosed with Condyloma.


Changed on 12/8/2009

266497 Before After
VAERS Form:
Age:17.0
Gender:Female
Location:Indiana
Vaccinated:2006-10-30
Onset:2006-10-30
Submitted:2006-11-10
Entered:2006-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) HPV (GARDASIL) / MERCK & CO. INC. - / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Disorientation, Dizziness, Dyspnoea, Nausea, Syncope

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Advil, Benadryl, Tylenol
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Patient fainted in waiting area less than five minutes after receiving Gardasil injection. Patient disoriented and c/o difficulty breathing when roused. C/O nausea, dizziness. Sent to ER & diagnosed as vasovagal syncope. Patient c/o sores in genital area"3 area 3 days post vaccination. Upon visit to doctor, diagnosed with Condyloma.


Changed on 5/14/2017

266497 Before After
VAERS Form:
Age:17.0
Gender:Female
Location:Indiana
Vaccinated:2006-10-30
Onset:2006-10-30
Submitted:2006-11-10
Entered:2006-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Disorientation, Dizziness, Dyspnoea, Nausea, Syncope, Syncope vasovagal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Advil, Benadryl, Tylenol
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Patient fainted in waiting area less than five minutes after receiving Gardasil injection. Patient disoriented and c/o difficulty breathing when roused. C/O nausea, dizziness. Sent to ER & diagnosed as vasovagal syncope. Patient c/o sores in genital area 3 days post vaccination. Upon visit to doctor, diagnosed with Condyloma.


Changed on 9/14/2017

266497 Before After
VAERS Form:(blank) 1
Age:17.0
Gender:Female
Location:Indiana
Vaccinated:2006-10-30
Onset:2006-10-30
Submitted:2006-11-10
Entered:2006-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Disorientation, Dizziness, Dyspnoea, Nausea, Syncope, Syncope vasovagal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Advil, Benadryl, Tylenol
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Patient fainted in waiting area less than five minutes after receiving Gardasil injection. Patient disoriented and c/o difficulty breathing when roused. C/O nausea, dizziness. Sent to ER & diagnosed as vasovagal syncope. Patient c/o sores in genital area 3 days post vaccination. Upon visit to doctor, diagnosed with Condyloma.


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