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History of Changes from the VAERS Wayback Machine |
VAERS ID: | 267463 |
VAERS Form: | |
Age: | |
Sex: | Female |
Location: | Unknown |
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. | - / - | - / IM |
Administered by: Other Purchased by: Unknown
Symptoms: 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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type':
Write-up: Information has been received from a nurse practitioner concerning a female who was vaccinated intramuscularly with a dose of Gardisil. The nurse practitioner reported that the patient /"experienced a vasovagal reaction and felt woozy and fainted within 5"minutes of the injection./" Unspecified medical attention was sought. At the time of the report, the patient''''s outcome was unknown. Additional information has been requested.
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. | - / - | - / IM |
Administered by: Other Purchased by: Unknown Other
Symptoms: 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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': (blank) WAES0610USA14150
Write-up: Information has been received from a nurse practitioner concerning a female who was vaccinated intramuscularly with a dose of Gardisil. The nurse practitioner reported that the patient /"experienced "experienced a vasovagal reaction and felt woozy and fainted within 5"minutes 5 minutes of the injection./" injection." Unspecified medical attention was sought. At the time of the report, the patient''''s patient''s outcome was unknown. Additional information has been requested.
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 / IM |
Administered by: Other Purchased by: Other
Symptoms: 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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0610USA14150
Write-up: Information has been received from a nurse practitioner concerning a female who was vaccinated intramuscularly with a dose of Gardisil. The nurse practitioner reported that the patient "experienced a vasovagal reaction and felt woozy and fainted within 5 minutes of the injection." Unspecified medical attention was sought. At the time of the report, the patient''s outcome was unknown. Additional information has been requested.
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 / IM |
Administered by: Other Purchased by: Other
Symptoms: 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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0610USA14150
Write-up: Information has been received from a nurse practitioner concerning a female who was vaccinated intramuscularly with a dose of Gardisil. The nurse practitioner reported that the patient "experienced a vasovagal reaction and felt woozy and fainted within 5 minutes of the injection." Unspecified medical attention was sought. At the time of the report, the patient''s outcome was unknown. Additional information has been requested.
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 / IM |
Administered by: Other Purchased by: Other
Symptoms: 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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0610USA14150
Write-up: Information has been received from a nurse practitioner concerning a female who was vaccinated intramuscularly with a dose of Gardisil. The nurse practitioner reported that the patient "experienced a vasovagal reaction and felt woozy and fainted within 5 minutes of the injection." Unspecified medical attention was sought. At the time of the report, the patient''s outcome was unknown. Additional information has been requested.
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. | - / - UNK | UN / IM |
Administered by: Other Purchased by: Other
Symptoms: 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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0610USA14150
Write-up: Information has been received from a nurse practitioner concerning a female who was vaccinated intramuscularly with a dose of Gardisil. The nurse practitioner reported that the patient "experienced a vasovagal reaction and felt woozy and fainted within 5 minutes of the injection." Unspecified medical attention was sought. At the time of the report, the patient''s outcome was unknown. Additional information has been requested.
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. | - / UNK | UN / IM |
Administered by: Other Purchased by: Other
Symptoms: 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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0610USA14150
Write-up: Information has been received from a nurse practitioner concerning a female who was vaccinated intramuscularly with a dose of Gardisil. The nurse practitioner reported that the patient "experienced a vasovagal reaction and felt woozy and fainted within 5 minutes of the injection." Unspecified medical attention was sought. At the time of the report, the patient''s outcome was unknown. Additional information has been requested.
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. | - / UNK | UN / IM |
Administered by: Other Purchased by: Other
Symptoms: 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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0610USA14150
Write-up: Information has been received from a nurse practitioner concerning a female who was vaccinated intramuscularly with a dose of Gardisil. The nurse practitioner reported that the patient "experienced a vasovagal reaction and felt woozy and fainted within 5 minutes of the injection." Unspecified medical attention was sought. At the time of the report, the patient''s outcome was unknown. Additional information has been requested.
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. | - / UNK | UN / IM |
Administered by: Other Purchased by: Other
Symptoms: 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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0610USA14150
Write-up: Information has been received from a nurse practitioner concerning a female who was vaccinated intramuscularly with a dose of Gardisil. The nurse practitioner reported that the patient "experienced a vasovagal reaction and felt woozy and fainted within 5 minutes of the injection." Unspecified medical attention was sought. At the time of the report, the patient''s outcome was unknown. Additional information has been requested.
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. | - / UNK | UN / IM |
Administered by: Other Purchased by: Other
Symptoms: 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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0610USA14150
Write-up: Information has been received from a nurse practitioner concerning a female who was vaccinated intramuscularly with a dose of Gardisil. The nurse practitioner reported that the patient "experienced a vasovagal reaction and felt woozy and fainted within 5 minutes of the injection." Unspecified medical attention was sought. At the time of the report, the patient''s outcome was unknown. Additional information has been requested.
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. | - / UNK | UN / IM |
Administered by: Other Purchased by: Other
Symptoms: 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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0610USA14150
Write-up: Information has been received from a nurse practitioner concerning a female who was vaccinated intramuscularly with a dose of Gardisil. The nurse practitioner reported that the patient "experienced a vasovagal reaction and felt woozy and fainted within 5 minutes of the injection." Unspecified medical attention was sought. At the time of the report, the patient''s outcome was unknown. Additional information has been requested.
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. | - / UNK | UN / IM |
Administered by: Other Purchased by: Other
Symptoms: 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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0610USA14150
Write-up: Information has been received from a nurse practitioner concerning a female who was vaccinated intramuscularly with a dose of Gardisil. The nurse practitioner reported that the patient "experienced a vasovagal reaction and felt woozy and fainted within 5 minutes of the injection." Unspecified medical attention was sought. At the time of the report, the patient''s outcome was unknown. Additional information has been requested.
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. | - / UNK | UN / IM |
Administered by: Other Purchased by: Other
Symptoms: 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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0610USA14150
Write-up: Information has been received from a nurse practitioner concerning a female who was vaccinated intramuscularly with a dose of Gardisil. The nurse practitioner reported that the patient "experienced a vasovagal reaction and felt woozy and fainted within 5 minutes of the injection." Unspecified medical attention was sought. At the time of the report, the patient''s outcome was unknown. Additional information has been requested.
Link To This Search Result:
https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=267463&WAYBACKHISTORY=ON
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