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This is VAERS ID 272196

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

272196
VAERS Form:
Age:16.0
Gender:Female
Location:New York
Vaccinated:2007-02-07
Onset:2007-02-07
Submitted:2007-02-13
Entered:2007-02-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB115BA / - - / -
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Blood pressure decreased, Fall, Head injury, Loss of consciousness, Scan brain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Allergic to Ceclor
Allergies:
Diagnostic Lab Data: Brain/C spin CT negative.
CDC 'Split Type':

Write-up:Approx 2-5 minutes after receiving vaccines patient passed out while getting dressed. There was no witness to the event. Patient lost consciousness and fell from the seated position hitting head in 3 places. Blood pressure had dropped. Patient had a short"episode of tremors during the recovery phase. Patient was allowed to rest and rehydrate until blood pressure returned to normal (100/80) 30 minutes later.


Changed on 12/8/2009

272196 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:New York
Vaccinated:2007-02-07
Onset:2007-02-07
Submitted:2007-02-13
Entered:2007-02-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB115BA / - - / -
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Blood pressure decreased, Fall, Head injury, Loss of consciousness, Tremor, Scan brain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Allergic to Ceclor
Allergies:
Diagnostic Lab Data: Brain/C spin CT negative.
CDC 'Split Type':

Write-up:Approx 2-5 minutes after receiving vaccines patient passed out while getting dressed. There was no witness to the event. Patient lost consciousness and fell from the seated position hitting head in 3 places. Blood pressure had dropped. Patient had a short"episode short episode of tremors during the recovery phase. Patient was allowed to rest and rehydrate until blood pressure returned to normal (100/80) 30 minutes later.


Changed on 9/14/2017

272196 Before After
VAERS Form:(blank) 1
Age:16.0
Gender:Female
Location:New York
Vaccinated:2007-02-07
Onset:2007-02-07
Submitted:2007-02-13
Entered:2007-02-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB115BA / - UNK - / -
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / - UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Blood pressure decreased, Fall, Head injury, Loss of consciousness, Tremor, Scan brain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Allergic to Ceclor
Allergies:
Diagnostic Lab Data: Brain/C spin CT negative.
CDC 'Split Type':

Write-up:Approx 2-5 minutes after receiving vaccines patient passed out while getting dressed. There was no witness to the event. Patient lost consciousness and fell from the seated position hitting head in 3 places. Blood pressure had dropped. Patient had a short episode of tremors during the recovery phase. Patient was allowed to rest and rehydrate until blood pressure returned to normal (100/80) 30 minutes later.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=272196&WAYBACKHISTORY=ON


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