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This is VAERS ID 272489

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

272489
VAERS Form:
Age:16.0
Gender:Female
Location:California
Vaccinated:2007-01-01
Onset:2007-01-01
Submitted:2007-02-14
Entered:2007-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 - / -

Administered by: Other      Purchased by: Unknown
Symptoms: Injury, Loss of consciousness, Neurological examination normal

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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: neurological, 01/07, comment: /"was ok/"
CDC 'Split Type':

Write-up:Information has been received from a registered nurse via a company representative concerning a 16 year old female who, /"the other night/", was vaccinated with a first dose of HPV vaccine (yeast) (lot# not reported). The nurse reported that girl passed o"ut in the office and hit her head after receiving a first dose of vaccine. The girl was unconscious in the office waiting room 3 to 4 minutes. It was reported that the patient was /"revived/" by using ammonia inhalant, and /"seemed to take longer than e


Changed on 12/8/2009

272489 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:California
Vaccinated:2007-01-01
Onset:2007-01-01
Submitted:2007-02-14
Entered:2007-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 - / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Injury, Loss of consciousness, Neurological examination normal

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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: neurological, 01/07, comment: /"was ok/" "was ok"
CDC 'Split Type': (blank) WAES0701USA03436

Write-up:Information has been received from a registered nurse via a company representative concerning a 16 year old female who, /"the "the other night/", night", was vaccinated with a first dose of HPV vaccine (yeast) (lot# not reported). The nurse reported that girl passed o"ut out in the office and hit her head after receiving a first dose of vaccine. The girl was unconscious in the office waiting room 3 to 4 minutes. It was reported that the patient was /"revived/" "revived" by using ammonia inhalant, and /"seemed "seemed to take longer than e expected to regain consciousness." The patient was administered an office neurological exam which was "ok and the patient was sent home", reported as recovered. The nurse also reported that it was unclear if this injection was painful. Additional information has been requested.


Changed on 9/14/2017

272489 Before After
VAERS Form:(blank) 1
Age:16.0
Gender:Female
Location:California
Vaccinated:2007-01-01
Onset:2007-01-01
Submitted:2007-02-14
Entered:2007-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 1 - / -

Administered by: Other      Purchased by: Other
Symptoms: Injury, Loss of consciousness, Neurological examination normal

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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: neurological, 01/07, comment: "was ok"
CDC 'Split Type': WAES0701USA03436

Write-up:Information has been received from a registered nurse via a company representative concerning a 16 year old female who, "the other night", was vaccinated with a first dose of HPV vaccine (yeast) (lot# not reported). The nurse reported that girl passed out in the office and hit her head after receiving a first dose of vaccine. The girl was unconscious in the office waiting room 3 to 4 minutes. It was reported that the patient was "revived" by using ammonia inhalant, and "seemed to take longer than expected to regain consciousness." The patient was administered an office neurological exam which was "ok and the patient was sent home", reported as recovered. The nurse also reported that it was unclear if this injection was painful. Additional information has been requested.


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