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History of Changes from the VAERS Wayback Machine |
First Appeared on 12/30/2006 |
VAERS ID: | 269232 |
VAERS Form: | |
Age: | 20.0 |
Gender: | Female |
Location: | Unknown |
Vaccinated: | 2006-11-01 |
Onset: | 2006-11-01 |
Submitted: | 2006-12-14 |
Entered: | 2006-12-18 |
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
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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 physician concerning a female patient in her 20''''s who in November 2006, was vaccinated with a dose of HPV vaccine. Immediately after administration, the patient passed out. Medical attention was sought. Subsequently,
Vaccinated: | 2006-11-01 |
Onset: | 2006-11-01 |
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. | - / - | UN / - |
Administered by: Other Purchased by: Unknown Other
Symptoms: Loss of consciousness
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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) WAES0611USA07572
Write-up: Information has been received from a physician concerning a female patient in her 20''''s 20''s who in November 2006, was vaccinated with a dose of HPV vaccine. Immediately after administration, the patient passed out. Medical attention was sought. Subsequently,"the Subsequently, the patient recovered. The physician explained that another physician from a different office administered the vaccination to the patient. Additional information has been requested. There was no product quality complaint involved.
Vaccinated: | 2006-11-01 |
Onset: | 2006-11-01 |
Submitted: | 2006-12-14 |
Entered: | 2006-12-18 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | - / - UNK | UN / - |
Administered by: Other Purchased by: Other
Symptoms: Loss of consciousness
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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': WAES0611USA07572
Write-up: Information has been received from a physician concerning a female patient in her 20''s who in November 2006, was vaccinated with a dose of HPV vaccine. Immediately after administration, the patient passed out. Medical attention was sought. Subsequently, the patient recovered. The physician explained that another physician from a different office administered the vaccination to the patient. Additional information has been requested. There was no product quality complaint involved.
Vaccinated: | 2006-11-01 |
Onset: | 2006-11-01 |
Submitted: | 2006-12-14 |
Entered: | 2006-12-18 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | - / UNK | UN / - |
Administered by: Other Purchased by: Other
Symptoms: Loss of consciousness
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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': WAES0611USA07572
Write-up: Information has been received from a physician concerning a female patient in her 20''s who in November 2006, was vaccinated with a dose of HPV vaccine. Immediately after administration, the patient passed out. Medical attention was sought. Subsequently, the patient recovered. The physician explained that another physician from a different office administered the vaccination to the patient. Additional information has been requested. There was no product quality complaint involved.
Link To This Search Result:
http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=269232&WAYBACKHISTORY=ON
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