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This is VAERS ID 266581

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 266581
Age:19.0
Gender:Female
Location:Virginia
Vaccinated:2006-10-13
Onset:2006-10-13
Submitted:2006-11-08
Entered:2006-11-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (FLUZONE) / AVENTIS PASTEUR, INC. U2165CA / 2 RA / IM
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. 0688F / 0 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Blood pressure decreased, Bradycardia, Heart rate irregular

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Fever~DTP (unknown mfr)~1~1~In Patient
Other Medications: Allegra, Nasolcrom, Acne meds, Bactrim
Current Illness: NONE
Preexisting Conditions: Acne, allergies to raw peaches, carrot, potatoes, kiwi, apples, cherries.
Diagnostic Lab Data: Skin prick tested for allergies.
CDC 'Split Type': Acne, allergies to raw peaches, carrot, potatoes, kiwi, apples, cherries.

Write-up:Vasovagal RXN. Pt HR decreased to 50 and BP decreased.


Changed on 12/8/2009

VAERS ID: 266581 Before After
Age:19.0
Gender:Female
Location:Virginia
Vaccinated:2006-10-13
Onset:2006-10-13
Submitted:2006-11-08
Entered:2006-11-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (FLUZONE) INFLUENZA (SEASONAL) (FLUZONE) / AVENTIS PASTEUR, INC. AVENTIS PASTEUR U2165CA / 2 RA / IM
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) HPV (GARDASIL) / MERCK & CO. INC. 0688F / 0 LA / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Blood pressure decreased, Bradycardia, Heart rate irregular

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Fever~DTP (unknown mfr)~1~1~In Patient
Other Medications: Allegra, Nasolcrom, Acne meds, Bactrim
Current Illness: NONE
Preexisting Conditions: Acne, allergies to raw peaches, carrot, potatoes, kiwi, apples, cherries.
Diagnostic Lab Data: Skin prick tested for allergies.
CDC 'Split Type': Acne, allergies to raw peaches, carrot, potatoes, kiwi, apples, cherries. (blank)

Write-up:Vasovagal RXN. Pt HR decreased to 50 and BP decreased.


Changed on 7/7/2013

VAERS ID: 266581 Before After
Age:19.0
Gender:Female
Location:Virginia
Vaccinated:2006-10-13
Onset:2006-10-13
Submitted:2006-11-08
Entered:2006-11-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / AVENTIS PASTEUR U2165CA / 2 RA / IM
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / AVENTIS PASTEUR U2165CA / 2 RA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0688F / 0 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Blood pressure decreased, Bradycardia, Heart rate irregular

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Fever~DTP (unknown mfr)~1~1~In Patient
Other Medications: Allegra, Nasolcrom, Acne meds, Bactrim
Current Illness: NONE
Preexisting Conditions: Acne, allergies to raw peaches, carrot, potatoes, kiwi, apples, cherries.
Diagnostic Lab Data: Skin prick tested for allergies.
CDC 'Split Type':

Write-up:Vasovagal RXN. Pt HR decreased to 50 and BP decreased.


Changed on 5/14/2017

VAERS ID: 266581 Before After
Age:19.0
Gender:Female
Location:Virginia
Vaccinated:2006-10-13
Onset:2006-10-13
Submitted:2006-11-08
Entered:2006-11-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / AVENTIS PASTEUR SANOFI PASTEUR U2165CA / 2 RA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0688F / 0 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Blood pressure decreased, Bradycardia, Heart rate irregular

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Fever~DTP (unknown mfr)~1~1~In (no brand name)~1~1.17~In Patient
Other Medications: Allegra, Nasolcrom, Acne meds, Bactrim
Current Illness: NONE
Preexisting Conditions: Acne, allergies to raw peaches, carrot, potatoes, kiwi, apples, cherries.
Diagnostic Lab Data: Skin prick tested for allergies.
CDC 'Split Type':

Write-up:Vasovagal RXN. Pt HR decreased to 50 and BP decreased.


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