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This is VAERS ID 272536

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

272536
VAERS Form:
Age:15.0
Gender:Female
Location:Pennsylvania
Vaccinated:2007-01-03
Onset:2007-01-03
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: Injection site pain, Syncope

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: UNK
CDC 'Split Type':

Write-up:Information has been received from a physician concerning his 15 year old daughter who on 03-JAN-2007 was vaccinated with a first dose of HPV VLP vaccine (yeast). On 03-JAN-2007 the patient fainted and experienced soreness at the injection site. Unspecifi"ed medical attention was sought. Subsequently, the patient recovered. No product quality complaint was involved. Additional information has been requested.


Changed on 12/8/2009

272536 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:Pennsylvania
Vaccinated:2007-01-03
Onset:2007-01-03
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: Injection site pain, Syncope

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: UNK
CDC 'Split Type': (blank) WAES0701USA04565

Write-up:Information has been received from a physician concerning his 15 year old daughter who on 03-JAN-2007 was vaccinated with a first dose of HPV VLP vaccine (yeast). On 03-JAN-2007 the patient fainted and experienced soreness at the injection site. Unspecifi"ed Unspecified medical attention was sought. Subsequently, the patient recovered. No product quality complaint was involved. Additional information has been requested.


Changed on 9/14/2017

272536 Before After
VAERS Form:(blank) 1
Age:15.0
Gender:Female
Location:Pennsylvania
Vaccinated:2007-01-03
Onset:2007-01-03
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: Injection site pain, Syncope

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: UNK
CDC 'Split Type': WAES0701USA04565

Write-up:Information has been received from a physician concerning his 15 year old daughter who on 03-JAN-2007 was vaccinated with a first dose of HPV VLP vaccine (yeast). On 03-JAN-2007 the patient fainted and experienced soreness at the injection site. Unspecified medical attention was sought. Subsequently, the patient recovered. No product quality complaint was involved. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=272536&WAYBACKHISTORY=ON


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