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This is VAERS ID 269412

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 269412
Age:16.0
Gender:Female
Location:Florida
Vaccinated:2006-12-19
Onset:2006-12-19
Submitted:2006-12-19
Entered:2006-12-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. 0961F / 0 LA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE AC52B012AA / 0 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1065F / 1 RA / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Dizziness, Syncope

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: atenolol - but not taken today
Current Illness: none
Preexisting Conditions: anxiety syncope
Diagnostic Lab Data: Bp 117/68 HR 85 after incident
CDC 'Split Type':

Write-up:Patient felt dizzy after dTaP, Varicella, and HPV administration. She had a syncopal episode lasting seconds, immediately recoverd with stable vital signs. To note patient has a past medical history significant for syncope and did not take her atenolo t"hat morning. She was sent to the ER for fluids and further monitoring.


Changed on 12/8/2009

VAERS ID: 269412 Before After
Age:16.0
Gender:Female
Location:Florida
Vaccinated:2006-12-19
Onset:2006-12-19
Submitted:2006-12-19
Entered:2006-12-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) HPV (GARDASIL) / MERCK & CO. INC. 0961F / 0 LA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE GLAXOSMITHKLINE BIOLOGICALS AC52B012AA / 0 LA / IM
VARCEL: VARICELLA (VARIVAX) VARICELLA (VARIVAX) / MERCK & CO. INC. 1065F / 1 RA / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Dizziness, Syncope

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: atenolol - but not taken today
Current Illness: none
Preexisting Conditions: anxiety syncope
Diagnostic Lab Data: Bp 117/68 HR 85 after incident
CDC 'Split Type':

Write-up:Patient felt dizzy after dTaP, Varicella, and HPV administration. She had a syncopal episode lasting seconds, immediately recoverd with stable vital signs. To note patient has a past medical history significant for syncope and did not take her atenolo t"hat that morning. She was sent to the ER for fluids and further monitoring.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=269412&WAYBACKHISTORY=ON


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