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This is VAERS ID 267431

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 267431
Age:12.0
Gender:Female
Location:California
Vaccinated:2006-10-04
Onset:2006-10-04
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (UNKNOWN MFR) / UNKNOWN MANUFACTURER - / - UN / -
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. - / - 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 registered nurse concerning a 12 year old female with no past medical history who on approximately 10/4/06 was vaccinated, into the arm, with a 0.5ml dose of HPV vaccine. Concomitant therapy included a dose of Hep A va"ccine. It was reported that the nurse rubbed the childs arm after the vaccination and the child passed out. The physician thought that it was a vasovagal reaction and revived her with ammonia. On approximately 10/04/06, the pt recovered. Additional inform


Changed on 12/8/2009

VAERS ID: 267431 Before After
Age:12.0
Gender:Female
Location:California
Vaccinated:2006-10-04
Onset:2006-10-04
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (UNKNOWN MFR) HEP A (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / -
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) HPV (GARDASIL) / MERCK & CO. INC. - / - 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) WAES0610USA08391

Write-up:Information has been received from a registered nurse concerning a 12 year old female with no past medical history who on approximately 10/4/06 was vaccinated, into the arm, with a 0.5ml dose of HPV vaccine. Concomitant therapy included a dose of Hep A va"ccine. vaccine. It was reported that the nurse rubbed the childs arm after the vaccination and the child passed out. The physician thought that it was a vasovagal reaction and revived her with ammonia. On approximately 10/04/06, the pt recovered. Additional inform information has been requested.


Changed on 3/14/2014

VAERS ID: 267431 Before After
Age:12.0
Gender:Female
Location:California
Vaccinated:2006-10-04
Onset:2006-10-04
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / - UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / - UN

Administered by: Other      Purchased by: Other
Symptoms: Loss of consciousness, Syncope vasovagal

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': WAES0610USA08391

Write-up:Information has been received from a registered nurse concerning a 12 year old female with no past medical history who on approximately 10/4/06 was vaccinated, into the arm, with a 0.5ml dose of HPV vaccine. Concomitant therapy included a dose of Hep A vaccine. It was reported that the nurse rubbed the childs arm after the vaccination and the child passed out. The physician thought that it was a vasovagal reaction and revived her with ammonia. On approximately 10/04/06, the pt recovered. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=267431&WAYBACKHISTORY=ON


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