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This is VAERS ID 271369

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 271369
Age:
Gender:Female
Location:New Jersey
Vaccinated:2007-01-10
Onset:2007-01-10
Submitted:2007-01-26
Entered:2007-01-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / -
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 - / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS - / - UN / -

Administered by: Other      Purchased by: Unknown
Symptoms: Convulsion, Loss of consciousness

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Information has been received from a Registered Nurse concerning a female patient (demographics not reported) who on 10-JAN-2007 was vaccinated intramuscularly with the first dose of Gardasil vaccine (yeast) (lot # not provided). Concomitant therapy inclu"ded BOOSTRIX and hepatitis A virus vaccine (manufacturer unknown). On 10-JAN-2007 immediately post vaccination the patient /"passed out and went into a seizure./" The patient sought unspecified medical attention. At the time of this report it was not repo


Changed on 12/8/2009

VAERS ID: 271369 Before After
Age:
Gender:Female
Location:New Jersey
Vaccinated:2007-01-10
Onset:2007-01-10
Submitted:2007-01-26
Entered:2007-01-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / - UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 - UN / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS - / - UN / - UN

Administered by: Other      Purchased by: Unknown Other
Symptoms: Convulsion, Loss of consciousness

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC 'Split Type': (blank) WAES0701USA03376

Write-up:Information has been received from a Registered Nurse concerning a female patient (demographics not reported) who on 10-JAN-2007 was vaccinated intramuscularly with the first dose of Gardasil vaccine (yeast) (lot # not provided). Concomitant therapy inclu"ded included BOOSTRIX and hepatitis A virus vaccine (manufacturer unknown). On 10-JAN-2007 immediately post vaccination the patient /"passed "passed out and went into a seizure./" seizure." The patient sought unspecified medical attention. At the time of this report it was not repo reported if the patient had recovered from her experience. Upon internal review the seizure was considered to be an other medical event. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=271369&WAYBACKHISTORY=ON


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