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This is VAERS ID 272487

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 272487
Age:14.0
Gender:Female
Location:Unknown
Vaccinated:2007-01-15
Onset:2007-01-15
Submitted:2007-02-14
Entered:2007-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Syncope

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

Write-up:Information has been received from a registered nurse concerning a 14 year old female who on 15-JAN-2007 was vaccinated, intramuscularly with the first dose of HPV vaccine (yeast), (lot # not reported). On 15-JAN-2007 the patient fainted after receiving t"he vaccination. The patient was seen in the Emergency Room (ER) following vaccination and /"no problems were found/". At the time of the report, it was unspecified, if the patient recovered. Additional information has been requested.


Changed on 12/8/2009

VAERS ID: 272487 Before After
Age:14.0
Gender:Female
Location:Unknown
Vaccinated:2007-01-15
Onset:2007-01-15
Submitted:2007-02-14
Entered:2007-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 - / IM

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

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC 'Split Type': (blank) WAES0701USA03429

Write-up:Information has been received from a registered nurse concerning a 14 year old female who on 15-JAN-2007 was vaccinated, intramuscularly with the first dose of HPV vaccine (yeast), (lot # not reported). On 15-JAN-2007 the patient fainted after receiving t"he the vaccination. The patient was seen in the Emergency Room (ER) following vaccination and /"no "no problems were found/". found". At the time of the report, it was unspecified, if the patient recovered. Additional information has been requested.


Changed on 2/5/2010

VAERS ID: 272487 Before After
Age:14.0
Gender:Female
Location:Unknown
Vaccinated:2007-01-15
Onset:2007-01-15
Submitted:2007-02-14
Entered:2007-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - 09611F / 0 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Syncope

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0701USA03429

Write-up:Information has been received from a registered nurse concerning a 14 year old female who on 15-JAN-2007 was vaccinated, intramuscularly with the first dose of HPV vaccine (yeast), (lot # not reported). On 15-JAN-2007 the patient fainted after receiving the vaccination. The patient was seen in the Emergency Room (ER) following vaccination and "no problems were found". At the time of the report, it was unspecified, if the patient recovered. Additional information has been requested.


Changed on 3/2/2010

VAERS ID: 272487 Before After
Age:14.0
Gender:Female
Location:Unknown North Carolina
Vaccinated:2007-01-15
Onset:2007-01-15
Submitted:2007-02-14
Entered:2007-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 09611F / 0 - / IM

Administered by: Other Private      Purchased by: Other Private
Symptoms: Syncope

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: Sulfonamide allergy, Penicillin allergy.
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK Blood pressure, 01/15/07 96/72; total heartbeat count, 01/15/07, 104; pulse oximetry, 01/15/07 99%
CDC 'Split Type': WAES0701USA03429

Write-up:Information has been received from a registered nurse concerning a 14 year old female who on 15-JAN-2007 was vaccinated, intramuscularly with the first dose of HPV vaccine (yeast), (lot # not reported). 654389/0961F). On 15-JAN-2007 the patient fainted after receiving the vaccination. The patient was seen in the Emergency Room (ER) following vaccination and "no problems were found". At the time of the report, it was unspecified, if the patient recovered. Additional information has been requested. was received on 11-APR-2007. The registered nurse indicated that on 15-JAN-2007 the patient''s blood pressure was 56/72 and heart rate was 104. On 15-JAN-2007, at 15:10, the patient was vaccinated with her first dose of Gardisil intramuscular (left deltoid), became pale immediately, laid down for approximately 5 minutes, got up, started walking down the hall, and passed out. The patient was taken to an ER, oxygen saturation was 99% (no other vital signs were taken). It was noted that the patient did report nausea. The patient did not experience rashes, hives, or difficulty breating. The patient was not ill at the time of vaccination. Additional information is not expected.


Changed on 4/7/2010

VAERS ID: 272487 Before After
Age:14.0
Gender:Female
Location:North Carolina
Vaccinated:2007-01-15
Onset:2007-01-15
Submitted:2007-02-14
Entered:2007-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 09611F / 0 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Loss of consciousness, Pallor, Syncope, Immediate post-injection reaction

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: Sulfonamide allergy, Penicillin allergy.
Preexisting Conditions:
Diagnostic Lab Data: Blood pressure, 01/15/07 96/72; total heartbeat count, 01/15/07, 104; pulse oximetry, 01/15/07 99%
CDC 'Split Type': WAES0701USA03429

Write-up:Information has been received from a registered nurse concerning a 14 year old female who on 15-JAN-2007 was vaccinated, intramuscularly with the first dose of HPV vaccine (yeast), (lot # 654389/0961F). On 15-JAN-2007 the patient fainted after receiving the vaccination. The patient was seen in the Emergency Room (ER) following vaccination and "no problems were found". At the time of the report, it was unspecified, if the patient recovered. Additional information was received on 11-APR-2007. The registered nurse indicated that on 15-JAN-2007 the patient''s blood pressure was 56/72 and heart rate was 104. On 15-JAN-2007, at 15:10, the patient was vaccinated with her first dose of Gardisil intramuscular (left deltoid), became pale immediately, laid down for approximately 5 minutes, got up, started walking down the hall, and passed out. The patient was taken to an ER, oxygen saturation was 99% (no other vital signs were taken). It was noted that the patient did report nausea. The patient did not experience rashes, hives, or difficulty breating. The patient was not ill at the time of vaccination. Additional information is not expected.


Changed on 6/14/2014

VAERS ID: 272487 Before After
Age:14.0
Gender:Female
Location:North Carolina
Vaccinated:2007-01-15
Onset:2007-01-15
Submitted:2007-02-14
Entered:2007-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 09611F / 0 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Loss of consciousness, Pallor, Syncope, Immediate post-injection reaction

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: Sulfonamide allergy, Penicillin allergy.
Preexisting Conditions:
Diagnostic Lab Data: Blood pressure, 01/15/07 96/72; total heartbeat count, 01/15/07, 104; pulse oximetry, 01/15/07 99%
CDC 'Split Type': WAES0701USA03429

Write-up:Information has been received from a registered nurse concerning a 14 year old female who on 15-JAN-2007 was vaccinated, intramuscularly with the first dose of HPV vaccine (yeast), (lot # 654389/0961F). On 15-JAN-2007 the patient fainted after receiving the vaccination. The patient was seen in the Emergency Room (ER) following vaccination and "no problems were found". At the time of the report, it was unspecified, if the patient recovered. Additional information was received on 11-APR-2007. The registered nurse indicated that on 15-JAN-2007 the patient''s blood pressure was 56/72 and heart rate was 104. On 15-JAN-2007, at 15:10, the patient was vaccinated with her first dose of Gardisil intramuscular (left deltoid), became pale immediately, laid down for approximately 5 minutes, got up, started walking down the hall, and passed out. The patient was taken to an ER, oxygen saturation was 99% (no other vital signs were taken). It was noted that the patient did report nausea. The patient did not experience rashes, hives, or difficulty breating. The patient was not ill at the time of vaccination. Additional information is not expected.


Changed on 5/14/2017

VAERS ID: 272487 Before After
Age:14.0
Gender:Female
Location:North Carolina
Vaccinated:2007-01-15
Onset:2007-01-15
Submitted:2007-02-14
Entered:2007-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 09611F / 0 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Loss of consciousness, Pallor, Syncope, Immediate post-injection reaction

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: Sulfonamide allergy, Penicillin allergy.
Preexisting Conditions:
Diagnostic Lab Data: Blood pressure, 01/15/07 96/72; total heartbeat count, 01/15/07, 104; pulse oximetry, 01/15/07 99%
CDC 'Split Type': WAES0701USA03429

Write-up:Information has been received from a registered nurse concerning a 14 year old female who on 15-JAN-2007 was vaccinated, intramuscularly with the first dose of HPV vaccine (yeast), (lot # 654389/0961F). On 15-JAN-2007 the patient fainted after receiving the vaccination. The patient was seen in the Emergency Room (ER) following vaccination and "no problems were found". At the time of the report, it was unspecified, if the patient recovered. Additional information was received on 11-APR-2007. The registered nurse indicated that on 15-JAN-2007 the patient''s blood pressure was 56/72 and heart rate was 104. On 15-JAN-2007, at 15:10, the patient was vaccinated with her first dose of Gardisil intramuscular (left deltoid), became pale immediately, laid down for approximately 5 minutes, got up, started walking down the hall, and passed out. The patient was taken to an ER, oxygen saturation was 99% (no other vital signs were taken). It was noted that the patient did report nausea. The patient did not experience rashes, hives, or difficulty breating. The patient was not ill at the time of vaccination. Additional information is not expected.


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