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History of Changes from the VAERS Wayback Machine |
VAERS ID: | 267491 |
VAERS Form: | |
Age: | |
Sex: | Female |
Location: | Virginia |
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: Syncope
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
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 registered nurse concerning a female pt who on an unspecified date was vaccinated with HPV vaccine. Subsequently, following the vaccination, the pt fainted. At the time of this report, the outcome of the event was unk."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. | - / - | UN / - |
Administered by: Other Purchased by: Unknown Other
Symptoms: Syncope
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
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) WAES0611USA02472
Write-up: Information has been received from a registered nurse concerning a female pt who on an unspecified date was vaccinated with HPV vaccine. Subsequently, following the vaccination, the pt fainted. At the time of this report, the outcome of the event was unk."Additional unk. 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 / - UN |
Administered by: Other Purchased by: Other
Symptoms: Syncope
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
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': WAES0611USA02472
Write-up: Information has been received from a registered nurse concerning a female pt who on an unspecified date was vaccinated with HPV vaccine. Subsequently, following the vaccination, the pt fainted. At the time of this report, the outcome of the event was unk. 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 / UN |
Administered by: Other Purchased by: Other
Symptoms: Syncope
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
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': WAES0611USA02472
Write-up: Information has been received from a registered nurse concerning a female pt who on an unspecified date was vaccinated with HPV vaccine. Subsequently, following the vaccination, the pt fainted. At the time of this report, the outcome of the event was unk. 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 / UN |
Administered by: Other Purchased by: Other
Symptoms: Syncope
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
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': WAES0611USA02472
Write-up: Information has been received from a registered nurse concerning a female pt who on an unspecified date was vaccinated with HPV vaccine. Subsequently, following the vaccination, the pt fainted. At the time of this report, the outcome of the event was unk. 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 / UN |
Administered by: Other Purchased by: Other
Symptoms: Syncope
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
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': WAES0611USA02472
Write-up: Information has been received from a registered nurse concerning a female pt who on an unspecified date was vaccinated with HPV vaccine. Subsequently, following the vaccination, the pt fainted. At the time of this report, the outcome of the event was unk. 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 / UN |
Administered by: Other Purchased by: Other
Symptoms: Syncope
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
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': WAES0611USA02472
Write-up: Information has been received from a registered nurse concerning a female pt who on an unspecified date was vaccinated with HPV vaccine. Subsequently, following the vaccination, the pt fainted. At the time of this report, the outcome of the event was unk. 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 / UN |
Administered by: Other Purchased by: Other
Symptoms: Syncope
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
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': WAES0611USA02472
Write-up: Information has been received from a registered nurse concerning a female pt who on an unspecified date was vaccinated with HPV vaccine. Subsequently, following the vaccination, the pt fainted. At the time of this report, the outcome of the event was unk. 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 / UN |
Administered by: Other Purchased by: Other
Symptoms: Syncope
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
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': WAES0611USA02472
Write-up: Information has been received from a registered nurse concerning a female pt who on an unspecified date was vaccinated with HPV vaccine. Subsequently, following the vaccination, the pt fainted. At the time of this report, the outcome of the event was unk. 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 / UN |
Administered by: Other Purchased by: Other
Symptoms: Syncope
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
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': WAES0611USA02472
Write-up: Information has been received from a registered nurse concerning a female pt who on an unspecified date was vaccinated with HPV vaccine. Subsequently, following the vaccination, the pt fainted. At the time of this report, the outcome of the event was unk. 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 / UN |
Administered by: Other Purchased by: Other
Symptoms: Syncope
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
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': WAES0611USA02472
Write-up: Information has been received from a registered nurse concerning a female pt who on an unspecified date was vaccinated with HPV vaccine. Subsequently, following the vaccination, the pt fainted. At the time of this report, the outcome of the event was unk. 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 / UN |
Administered by: Other Purchased by: Other
Symptoms: Syncope
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
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': WAES0611USA02472
Write-up: Information has been received from a registered nurse concerning a female pt who on an unspecified date was vaccinated with HPV vaccine. Subsequently, following the vaccination, the pt fainted. At the time of this report, the outcome of the event was unk. 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 / UN |
Administered by: Other Purchased by: Other
Symptoms: Syncope
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
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': WAES0611USA02472
Write-up: Information has been received from a registered nurse concerning a female pt who on an unspecified date was vaccinated with HPV vaccine. Subsequently, following the vaccination, the pt fainted. At the time of this report, the outcome of the event was unk. Additional information has been requested.
Link To This Search Result:
https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=267491&WAYBACKHISTORY=ON
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