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This is VAERS ID 271142

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

271142
VAERS Form:
Age:
Gender:Female
Location:Unknown
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. - / - - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Syncope

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

Write-up:Information has been received from a clinical manager concerning a female who on /"13-DEC-2006 or 14-DEC-2006/" was vaccinated with HPV rL1 6 11 16 18 VLP vaccine (yeast). On 13-DEC-2006, or 14-DEC-2006, the patient fainted almost immediately after receiv"ing the vaccination. The patient sought unspecified medical attention. Additional information has been requested.


Changed on 12/8/2009

271142 Before After
VAERS Form:
Age:
Gender:Female
Location:Unknown
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. - / - - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Syncope

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': (blank) WAES0612USA03396

Write-up:Information has been received from a clinical manager concerning a female who on /"13-DEC-2006 "13-DEC-2006 or 14-DEC-2006/" 14-DEC-2006" was vaccinated with HPV rL1 6 11 16 18 VLP vaccine (yeast). On 13-DEC-2006, or 14-DEC-2006, the patient fainted almost immediately after receiv"ing receiving the vaccination. The patient sought unspecified medical attention. Additional information has been requested.


Changed on 6/14/2014

271142 Before After
VAERS Form:
Age:
Gender:Female
Location:Unknown
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. - / - - / IM

Administered by: Other      Purchased by: Other
Symptoms: Syncope

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0612USA03396

Write-up:Information has been received from a clinical manager concerning a female who on "13-DEC-2006 or 14-DEC-2006" was vaccinated with HPV rL1 6 11 16 18 VLP vaccine (yeast). On 13-DEC-2006, or 14-DEC-2006, the patient fainted almost immediately after receiving the vaccination. The patient sought unspecified medical attention. Additional information has been requested.


Changed on 5/14/2017

271142 Before After
VAERS Form:
Age:
Gender:Female
Location:Unknown
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. - / - - / IM

Administered by: Other      Purchased by: Other
Symptoms: Syncope

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0612USA03396

Write-up:Information has been received from a clinical manager concerning a female who on "13-DEC-2006 or 14-DEC-2006" was vaccinated with HPV rL1 6 11 16 18 VLP vaccine (yeast). On 13-DEC-2006, or 14-DEC-2006, the patient fainted almost immediately after receiving the vaccination. The patient sought unspecified medical attention. Additional information has been requested.


Changed on 9/14/2017

271142 Before After
VAERS Form:(blank) 1
Age:
Gender:Female
Location:Unknown
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. - / - UNK - / IM

Administered by: Other      Purchased by: Other
Symptoms: Syncope

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0612USA03396

Write-up:Information has been received from a clinical manager concerning a female who on "13-DEC-2006 or 14-DEC-2006" was vaccinated with HPV rL1 6 11 16 18 VLP vaccine (yeast). On 13-DEC-2006, or 14-DEC-2006, the patient fainted almost immediately after receiving the vaccination. The patient sought unspecified medical attention. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=271142&WAYBACKHISTORY=ON


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