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This is VAERS ID 269221

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 269221
Age:
Gender:Female
Location:Arizona
Vaccinated:2006-11-08
Onset:2006-11-08
Submitted:2006-12-14
Entered:2006-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. 0800F / 0 UN / -

Administered by: Private      Purchased by: Unknown
Symptoms: Blood pressure decreased, Dizziness, Syncope

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: Allergic reaction to antibiotics.
Diagnostic Lab Data: Blood pressure 11/08/06 low.
CDC 'Split Type':

Write-up:Information has been received from a health professional concerning a female patient with an allergy to amoxicillin and clavulanate potassium who on 08 Nov 2006 at 11:00 AM was vaccinated in the right deltoid with the first dose of HPV vaccine. (Lot #6545"40/0800F) There was no illnesses at the time of vaccination. On 08 Nov 2006, at 1PM, following vaccination, the patient became lightheaded. Then while walking out of the office, the patient had a syncopal episode. It was reported that there was no detect


Changed on 12/8/2009

VAERS ID: 269221 Before After
Age:
Gender:Female
Location:Arizona
Vaccinated:2006-11-08
Onset:2006-11-08
Submitted:2006-12-14
Entered:2006-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) HPV (GARDASIL) / MERCK & CO. INC. 0800F / 0 UN / -

Administered by: Private      Purchased by: Unknown Private
Symptoms: Blood pressure decreased, Dizziness, Syncope

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: Allergic reaction to antibiotics.
Diagnostic Lab Data: Blood pressure 11/08/06 low.
CDC 'Split Type': (blank) WAES0611USA06802

Write-up:Information has been received from a health professional concerning a female patient with an allergy to amoxicillin and clavulanate potassium who on 08 Nov 2006 at 11:00 AM was vaccinated in the right deltoid with the first dose of HPV vaccine. (Lot #6545"40/0800F) #654540/0800F) There was no illnesses at the time of vaccination. On 08 Nov 2006, at 1PM, following vaccination, the patient became lightheaded. Then while walking out of the office, the patient had a syncopal episode. It was reported that there was no detect detectable seizure activity and the patient was not post ictal. The patient''s blood pressure was low, however not documented. The patient subsequently recovered with elevation of her feet and after five minutes, the patient was sent home. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=269221&WAYBACKHISTORY=ON


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