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This is VAERS ID 267439

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 267439
Age:15.0
Gender:Female
Location:California
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
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: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Information has been received from a physician concerning a 15 year old female who on an unspecified date was vaccinated with the first dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) (Lot# not provided). The physician reported that the patient /"was admin"istered the shot and then fainted/passed out/". Unspecified medical attention was sought. The physician reported that the patient recovered from the event. Additional information has been requested.


Changed on 12/8/2009

VAERS ID: 267439 Before After
Age:15.0
Gender:Female
Location:California
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
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: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC 'Split Type': (blank) WAES0610USA10773

Write-up:Information has been received from a physician concerning a 15 year old female who on an unspecified date was vaccinated with the first dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) (Lot# not provided). The physician reported that the patient /"was admin"istered "was administered the shot and then fainted/passed out/". out". Unspecified medical attention was sought. The physician reported that the patient recovered from the event. Additional information has been requested.


Changed on 3/14/2014

VAERS ID: 267439 Before After
Age:15.0
Gender:Female
Location:California
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - 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: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC 'Split Type': WAES0610USA10773

Write-up:Information has been received from a physician concerning a 15 year old female who on an unspecified date was vaccinated with the first dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) (Lot# not provided). The physician reported that the patient "was administered the shot and then fainted/passed out". Unspecified medical attention was sought. The physician reported that the patient recovered from the event. Additional information has been requested.


Changed on 6/14/2014

VAERS ID: 267439 Before After
Age:15.0
Gender:Female
Location:California
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - 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: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC 'Split Type': WAES0610USA10773

Write-up:Information has been received from a physician concerning a 15 year old female who on an unspecified date was vaccinated with the first dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) (Lot# not provided). The physician reported that the patient "was administered the shot and then fainted/passed out". Unspecified medical attention was sought. The physician reported that the patient recovered from the event. Additional information has been requested.


Changed on 3/14/2015

VAERS ID: 267439 Before After
Age:15.0
Gender:Female
Location:California
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - 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: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC 'Split Type': WAES0610USA10773

Write-up:Information has been received from a physician concerning a 15 year old female who on an unspecified date was vaccinated with the first dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) (Lot# not provided). The physician reported that the patient "was administered the shot and then fainted/passed out". Unspecified medical attention was sought. The physician reported that the patient recovered from the event. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=267439&WAYBACKHISTORY=ON


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