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This is VAERS ID 267411

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 267411
Age:17.0
Gender:Female
Location:Unknown
Vaccinated:2006-10-02
Onset:2006-10-02
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (UNKNOWN MFR) / UNKNOWN MANUFACTURER - / - UN / -
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. 0688F / - UN / -

Administered by: Other      Purchased by: Unknown
Symptoms: Loss of consciousness

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up:Information has been received from a physician concerning a 17 year old female pt with on past medical history who on 10/2/06 was vaccainted with a dose of HPV vaccine, lot 653735/0688F. Concomitant therapy included an unspecified flu shot. It was reporte"d that after receiving HPV vaccine, the pt passed out. Medical attention was sought. the pt recovered the same day. No further information is available.


Changed on 12/8/2009

VAERS ID: 267411 Before After
Age:17.0
Gender:Female
Location:Unknown
Vaccinated:2006-10-02
Onset:2006-10-02
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (UNKNOWN MFR) INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / -
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) HPV (GARDASIL) / MERCK & CO. INC. 0688F / - UN / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Loss of consciousness

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': (blank) WAES0610USA01138

Write-up:Information has been received from a physician concerning a 17 year old female pt with on past medical history who on 10/2/06 was vaccainted with a dose of HPV vaccine, lot 653735/0688F. Concomitant therapy included an unspecified flu shot. It was reporte"d reported that after receiving HPV vaccine, the pt passed out. Medical attention was sought. the pt recovered the same day. No further information is available.


Changed on 7/7/2013

VAERS ID: 267411 Before After
Age:17.0
Gender:Female
Location:Unknown
Vaccinated:2006-10-02
Onset:2006-10-02
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / -
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / -
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0688F / - UN / -

Administered by: Other      Purchased by: Other
Symptoms: Loss of consciousness

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0610USA01138

Write-up:Information has been received from a physician concerning a 17 year old female pt with on past medical history who on 10/2/06 was vaccainted with a dose of HPV vaccine, lot 653735/0688F. Concomitant therapy included an unspecified flu shot. It was reported that after receiving HPV vaccine, the pt passed out. Medical attention was sought. the pt recovered the same day. No further information is available.


Changed on 3/14/2014

VAERS ID: 267411 Before After
Age:17.0
Gender:Female
Location:Unknown
Vaccinated:2006-10-02
Onset:2006-10-02
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / - UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0688F / - UN / - UN

Administered by: Other      Purchased by: Other
Symptoms: Loss of consciousness

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0610USA01138

Write-up:Information has been received from a physician concerning a 17 year old female pt with on past medical history who on 10/2/06 was vaccainted with a dose of HPV vaccine, lot 653735/0688F. Concomitant therapy included an unspecified flu shot. It was reported that after receiving HPV vaccine, the pt passed out. Medical attention was sought. the pt recovered the same day. No further information is available.


Changed on 12/14/2016

VAERS ID: 267411 Before After
Age:17.0
Gender:Female
Location:Unknown
Vaccinated:2006-10-02
Onset:2006-10-02
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / UN
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0688F / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Loss of consciousness

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0610USA01138

Write-up:Information has been received from a physician concerning a 17 year old female pt with on past medical history who on 10/2/06 was vaccainted with a dose of HPV vaccine, lot 653735/0688F. Concomitant therapy included an unspecified flu shot. It was reported that after receiving HPV vaccine, the pt passed out. Medical attention was sought. the pt recovered the same day. No further information is available.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=267411&WAYBACKHISTORY=ON


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