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This is VAERS ID 271105

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 271105
Age:
Gender:Female
Location:Maryland
Vaccinated:2006-12-13
Onset:2006-12-13
Submitted:2007-01-16
Entered:2007-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0961F / 0 - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Heart rate normal, Pallor, Syncope

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: vital sign 12/13/06 - normal
CDC 'Split Type':

Write-up:Information has been received from a registered nurse concerning a female patient who on 13-Dec-2006 was vaccinated intramuscularly in the left deltoid with the first dose of Gardasil vaccine (yeast) (0.5 ml) (lot#654389/0961F). There was no concomitant m"edication. On 13-Dec-2006, shortly after vaccination the patient fainted and her skin color was pale. The patient was aroused by shaking her right arm and with smelling salts. The patient''''s vital signs were found to be normal upon discharge from the offi


Changed on 12/8/2009

VAERS ID: 271105 Before After
Age:
Gender:Female
Location:Maryland
Vaccinated:2006-12-13
Onset:2006-12-13
Submitted:2007-01-16
Entered:2007-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0961F / 0 - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Heart rate normal, Pallor, Syncope

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: vital sign 12/13/06 - normal
CDC 'Split Type': (blank) WAES0612USA02247

Write-up:Information has been received from a registered nurse concerning a female patient who on 13-Dec-2006 was vaccinated intramuscularly in the left deltoid with the first dose of Gardasil vaccine (yeast) (0.5 ml) (lot#654389/0961F). There was no concomitant m"edication. medication. On 13-Dec-2006, shortly after vaccination the patient fainted and her skin color was pale. The patient was aroused by shaking her right arm and with smelling salts. The patient''''s patient''s vital signs were found to be normal upon discharge from the offi office. No further details were provided. Additional information has been requested.


Changed on 2/5/2010

VAERS ID: 271105 Before After
Age:(blank) 17.0
Gender:Female
Location:Maryland
Vaccinated:2006-12-13
Onset:2006-12-13
Submitted:2007-01-16
Entered:2007-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0961F / 0 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Heart rate normal, Pallor, Syncope

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: vital sign 12/13/06 - normal
CDC 'Split Type': WAES0612USA02247

Write-up:Information has been received from a registered nurse concerning a female patient who on 13-Dec-2006 was vaccinated intramuscularly in the left deltoid with the first dose of Gardasil vaccine (yeast) (0.5 ml) (lot#654389/0961F). There was no concomitant medication. On 13-Dec-2006, shortly after vaccination the patient fainted and her skin color was pale. The patient was aroused by shaking her right arm and with smelling salts. The patient''s vital signs were found to be normal upon discharge from the office. No further details were provided. Additional information has been requested.


Changed on 5/11/2010

VAERS ID: 271105 Before After
Age:17.0
Gender:Female
Location:Maryland
Vaccinated:2006-12-13
Onset:2006-12-13
Submitted:2007-01-16
Entered:2007-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0961F / 0 - LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Heart rate normal, Pallor, Syncope

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: UNK Unknown
Diagnostic Lab Data: vital sign 12/13/06 - normal
CDC 'Split Type': WAES0612USA02247

Write-up:Information has been received from a registered nurse concerning a female patient who on 13-Dec-2006 was vaccinated intramuscularly in the left deltoid with the first dose of Gardasil vaccine (yeast) (0.5 ml) (lot#654389/0961F). There was no concomitant medication. On 13-Dec-2006, shortly after vaccination vaccination, the patient fainted and her skin color was pale. The patient was aroused by shaking her right arm and with smelling salts. The patient''s vital signs were found to be normal upon discharge from the office. No further details were provided. Additional information has been requested. This is in follow-up to report(s) previously submitted on 1/16/2007. Follow up information received from the physician stated that on 13-DEC-2006 the injection of GARDASIL was administered by a medical assistant. It was reported that immediately after receiving the vaccination the patient had a syncopal episode. It was reported that the patient became hypotensive (actual blood pressure measurement not provided) and diaphoretic and responded to ammonia salts, being placed in the Trendelenburg and hydration, taken by mouth. It was reported that patient recovered from the event. Additional information has been requested.


Changed on 7/31/2010

VAERS ID: 271105 Before After
Age:17.0
Gender:Female
Location:Maryland
Vaccinated:2006-12-13
Onset:2006-12-13
Submitted:2007-01-16
Entered:2007-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0961F / 0 LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Hyperhidrosis, Hypotension, Pallor, Syncope, Immediate post-injection reaction

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: vital sign 12/13/06 - normal
CDC 'Split Type': WAES0612USA02247

Write-up:Information has been received from a registered nurse concerning a female patient who on 13-Dec-2006 was vaccinated intramuscularly in the left deltoid with the first dose of Gardasil vaccine (yeast) (0.5 ml) (lot#654389/0961F). There was no concomitant medication. On 13-Dec-2006, shortly after vaccination, the patient fainted and her skin color was pale. The patient was aroused by shaking her right arm and with smelling salts. The patient''s vital signs were found to be normal upon discharge from the office. No further details were provided. Additional information has been requested. This is in follow-up to report(s) previously submitted on 1/16/2007. Follow up information received from the physician stated that on 13-DEC-2006 the injection of GARDASIL was administered by a medical assistant. It was reported that immediately after receiving the vaccination the patient had a syncopal episode. It was reported that the patient became hypotensive (actual blood pressure measurement not provided) and diaphoretic and responded to ammonia salts, being placed in the Trendelenburg and hydration, taken by mouth. It was reported that patient recovered from the event. Additional information has been requested.


Changed on 6/14/2014

VAERS ID: 271105 Before After
Age:17.0
Gender:Female
Location:Maryland
Vaccinated:2006-12-13
Onset:2006-12-13
Submitted:2007-01-16
Entered:2007-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0961F / 0 LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Hyperhidrosis, Hypotension, Pallor, Syncope, Immediate post-injection reaction

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: vital sign 12/13/06 - normal
CDC 'Split Type': WAES0612USA02247

Write-up:Information has been received from a registered nurse concerning a female patient who on 13-Dec-2006 was vaccinated intramuscularly in the left deltoid with the first dose of Gardasil vaccine (yeast) (0.5 ml) (lot#654389/0961F). There was no concomitant medication. On 13-Dec-2006, shortly after vaccination, the patient fainted and her skin color was pale. The patient was aroused by shaking her right arm and with smelling salts. The patient''s vital signs were found to be normal upon discharge from the office. No further details were provided. Additional information has been requested. This is in follow-up to report(s) previously submitted on 1/16/2007. Follow up information received from the physician stated that on 13-DEC-2006 the injection of GARDASIL was administered by a medical assistant. It was reported that immediately after receiving the vaccination the patient had a syncopal episode. It was reported that the patient became hypotensive (actual blood pressure measurement not provided) and diaphoretic and responded to ammonia salts, being placed in the Trendelenburg and hydration, taken by mouth. It was reported that patient recovered from the event. Additional information has been requested.


Changed on 5/14/2017

VAERS ID: 271105 Before After
Age:17.0
Gender:Female
Location:Maryland
Vaccinated:2006-12-13
Onset:2006-12-13
Submitted:2007-01-16
Entered:2007-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0961F / 0 LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Hyperhidrosis, Hypotension, Pallor, Syncope, Immediate post-injection reaction

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: vital sign 12/13/06 - normal
CDC 'Split Type': WAES0612USA02247

Write-up:Information has been received from a registered nurse concerning a female patient who on 13-Dec-2006 was vaccinated intramuscularly in the left deltoid with the first dose of Gardasil vaccine (yeast) (0.5 ml) (lot#654389/0961F). There was no concomitant medication. On 13-Dec-2006, shortly after vaccination, the patient fainted and her skin color was pale. The patient was aroused by shaking her right arm and with smelling salts. The patient''s vital signs were found to be normal upon discharge from the office. No further details were provided. Additional information has been requested. This is in follow-up to report(s) previously submitted on 1/16/2007. Follow up information received from the physician stated that on 13-DEC-2006 the injection of GARDASIL was administered by a medical assistant. It was reported that immediately after receiving the vaccination the patient had a syncopal episode. It was reported that the patient became hypotensive (actual blood pressure measurement not provided) and diaphoretic and responded to ammonia salts, being placed in the Trendelenburg and hydration, taken by mouth. It was reported that patient recovered from the event. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=271105&WAYBACKHISTORY=ON


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