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This is VAERS ID 270964

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 270964
Age:14.0
Gender:Female
Location:Unknown
Vaccinated:2006-12-20
Onset:2006-12-20
Submitted:2007-01-22
Entered:2007-01-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / -
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0961F / 1 - / -

Administered by: Other      Purchased by: Unknown
Symptoms: Convulsion, Syncope, Vaccine positive rechallenge

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Migraine
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up:Initial and follow-up information has been received from a physician concerning a year old female with no known allergies and a history of /"occasional/" migraines who on an unspecified date was vaccinated with the first dose of Gardasil (yeast) (lot numb"er 654540/0800F). Concomitant therapy included hepatitis A virus vaccine (unspecified). Subsequent to the first dose, the patient experienced fainting and /"signs of seizure/". Clinical outcome was not reported. On 20-DEC-2006 (also reported as 20-DEC-200


Changed on 12/8/2009

VAERS ID: 270964 Before After
Age:14.0
Gender:Female
Location:Unknown
Vaccinated:2006-12-20
Onset:2006-12-20
Submitted:2007-01-22
Entered:2007-01-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / - UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0961F / 1 - UN / - UN

Administered by: Other      Purchased by: Unknown Other
Symptoms: Convulsion, Syncope, Vaccine positive rechallenge

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Migraine
Diagnostic Lab Data: NONE
CDC 'Split Type': (blank) WAES0701USA01090

Write-up:Initial and follow-up information has been received from a physician concerning a year old female with no known allergies and a history of /"occasional/" "occasional" migraines who on an unspecified date was vaccinated with the first dose of Gardasil GARDASIL (yeast) (lot numb"er number 654540/0800F). Concomitant therapy included hepatitis A virus vaccine (unspecified). Subsequent to the first dose, the patient experienced fainting and /"signs "signs of seizure/". seizure". Clinical outcome was not reported. On 20-DEC-2006 (also reported as 20-DEC-200 20-DEC-2007), the patient was vaccinated with a second dose of GARDASIL (yeast) (lot number 654389/0961F). On 20-DEC-2006 (also reported as 20-DEC-2007), the patient experienced fainting. Clinical outcome was not reported. Signs of seizure was considered an other important medical event. Additional information has been requested.


Changed on 1/5/2010

VAERS ID: 270964 Before After
Age:14.0
Gender:Female
Location:Unknown
Vaccinated:2006-12-20
Onset:2006-12-20
Submitted:2007-01-22
Entered:2007-01-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (NO BRAND NAME) HEP A (VAQTA) / UNKNOWN MANUFACTURER MERCK & CO. INC. - 0961F / - UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0961F - / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Convulsion, Syncope, Vaccine positive rechallenge

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Migraine
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0701USA01090

Write-up:Initial and follow-up information has been received from a physician concerning a year old female with no known allergies and a history of "occasional" migraines who on an unspecified date was vaccinated with the first dose of GARDASIL (yeast) (lot number 654540/0800F). Concomitant therapy included hepatitis A virus vaccine (unspecified). Subsequent to the first dose, the patient experienced fainting and "signs of seizure". Clinical outcome was not reported. On 20-DEC-2006 (also reported as 20-DEC-2007), the patient was vaccinated with a second dose of GARDASIL (yeast) (lot number 654389/0961F). On 20-DEC-2006 (also reported as 20-DEC-2007), the patient experienced fainting. Clinical outcome was not reported. Signs of seizure was considered an other important medical event. Additional information has been requested.


Changed on 7/31/2010

VAERS ID: 270964 Before After
Age:14.0
Gender:Female
Location:Unknown
Vaccinated:2006-12-20
Onset:2006-12-20
Submitted:2007-01-22
Entered:2007-01-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0961F / - UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Convulsion, Syncope, Vaccine positive rechallenge

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Migraine
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0701USA01090

Write-up:Initial and follow-up information has been received from a physician concerning a year old female with no known allergies and a history of "occasional" migraines who on an unspecified date was vaccinated with the first dose of GARDASIL (yeast) (lot number 654540/0800F). Concomitant therapy included hepatitis A virus vaccine (unspecified). Subsequent to the first dose, the patient experienced fainting and "signs of seizure". Clinical outcome was not reported. On 20-DEC-2006 (also reported as 20-DEC-2007), the patient was vaccinated with a second dose of GARDASIL (yeast) (lot number 654389/0961F). On 20-DEC-2006 (also reported as 20-DEC-2007), the patient experienced fainting. Clinical outcome was not reported. Signs of seizure was considered an other important medical event. Additional information has been requested.


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