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This is VAERS ID 270268

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

270268
VAERS Form:
Age:18.0
Gender:Female
Location:Pennsylvania
Vaccinated:2006-12-08
Onset:2006-12-08
Submitted:2007-01-05
Entered:2007-01-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / -

Administered by: Other      Purchased by: Unknown
Symptoms: Fear, Pallor, Presyncope

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: NONE
Current Illness:
Preexisting Conditions: Fear
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type':

Write-up:information has been received from a physician concerning a 16 year old female who on 08 Dec 2006 was vaccinated in the arm with a pre filled syringe of HPV Vaccine. There was no concomitant medication. On 08 Dec 2006, immediately following the vaccinatio"n, the patient turned white and nearly passed out. The patient was not hospitalized and was not pregnant. Subsequently, the patient fully recovered. The physician felt that the events were not a result of the vaccine, however a result of the patient being


Changed on 12/8/2009

270268 Before After
VAERS Form:
Age:18.0
Gender:Female
Location:Pennsylvania
Vaccinated:2006-12-08
Onset:2006-12-08
Submitted:2007-01-05
Entered:2007-01-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Fear, Pallor, Presyncope

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: NONE
Current Illness:
Preexisting Conditions: Fear
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': (blank) WAES0612USA01386

Write-up:information has been received from a physician concerning a 16 year old female who on 08 Dec 2006 was vaccinated in the arm with a pre filled syringe of HPV Vaccine. There was no concomitant medication. On 08 Dec 2006, immediately following the vaccinatio"n, vaccination, the patient turned white and nearly passed out. The patient was not hospitalized and was not pregnant. Subsequently, the patient fully recovered. The physician felt that the events were not a result of the vaccine, however a result of the patient being afraid of injections. Additional information has been requested.


Changed on 6/14/2014

270268 Before After
VAERS Form:
Age:18.0
Gender:Female
Location:Pennsylvania
Vaccinated:2006-12-08
Onset:2006-12-08
Submitted:2007-01-05
Entered:2007-01-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / -

Administered by: Other      Purchased by: Other
Symptoms: Fear, Pallor, Presyncope

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: NONE
Current Illness:
Preexisting Conditions: Fear
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0612USA01386

Write-up:information has been received from a physician concerning a 16 year old female who on 08 Dec 2006 was vaccinated in the arm with a pre filled syringe of HPV Vaccine. There was no concomitant medication. On 08 Dec 2006, immediately following the vaccination, the patient turned white and nearly passed out. The patient was not hospitalized and was not pregnant. Subsequently, the patient fully recovered. The physician felt that the events were not a result of the vaccine, however a result of the patient being afraid of injections. Additional information has been requested.


Changed on 5/14/2017

270268 Before After
VAERS Form:
Age:18.0
Gender:Female
Location:Pennsylvania
Vaccinated:2006-12-08
Onset:2006-12-08
Submitted:2007-01-05
Entered:2007-01-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / -

Administered by: Other      Purchased by: Other
Symptoms: Fear, Pallor, Presyncope

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: NONE
Current Illness:
Preexisting Conditions: Fear
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0612USA01386

Write-up:information has been received from a physician concerning a 16 year old female who on 08 Dec 2006 was vaccinated in the arm with a pre filled syringe of HPV Vaccine. There was no concomitant medication. On 08 Dec 2006, immediately following the vaccination, the patient turned white and nearly passed out. The patient was not hospitalized and was not pregnant. Subsequently, the patient fully recovered. The physician felt that the events were not a result of the vaccine, however a result of the patient being afraid of injections. Additional information has been requested.


Changed on 9/14/2017

270268 Before After
VAERS Form:(blank) 1
Age:18.0
Gender:Female
Location:Pennsylvania
Vaccinated:2006-12-08
Onset:2006-12-08
Submitted:2007-01-05
Entered:2007-01-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UNK UN / -

Administered by: Other      Purchased by: Other
Symptoms: Fear, Pallor, Presyncope

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: NONE
Current Illness:
Preexisting Conditions: Fear
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0612USA01386

Write-up:information has been received from a physician concerning a 16 year old female who on 08 Dec 2006 was vaccinated in the arm with a pre filled syringe of HPV Vaccine. There was no concomitant medication. On 08 Dec 2006, immediately following the vaccination, the patient turned white and nearly passed out. The patient was not hospitalized and was not pregnant. Subsequently, the patient fully recovered. The physician felt that the events were not a result of the vaccine, however a result of the patient being afraid of injections. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=270268&WAYBACKHISTORY=ON


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