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This is VAERS ID 272614

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

272614
VAERS Form:
Age:
Gender:Female
Location:Massachusetts
Vaccinated:2007-01-22
Onset:2007-01-22
Submitted:2007-02-14
Entered:2007-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: 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 a female patient who in /"the week of 22-JAN-2007/" was vaccinated IM with a 0.5 ml dose of HPV vaccine (yeast). After vaccination, the patient fainted. Unspecified medical attention was sought."Subsequently, the patient recovered. No product quality complaint was involved. Additional information has been requested.


Changed on 12/8/2009

272614 Before After
VAERS Form:
Age:
Gender:Female
Location:Massachusetts
Vaccinated:2007-01-22
Onset:2007-01-22
Submitted:2007-02-14
Entered:2007-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: 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) WAES0702USA00129

Write-up:Information has been received from a physician concerning a female patient who in /"the "the week of 22-JAN-2007/" 22-JAN-2007" was vaccinated IM with a 0.5 ml dose of HPV vaccine (yeast). After vaccination, the patient fainted. Unspecified medical attention was sought."Subsequently, sought. Subsequently, the patient recovered. No product quality complaint was involved. Additional information has been requested.


Changed on 2/5/2010

272614 Before After
VAERS Form:
Age:(blank) 15.0
Gender:Female
Location:Massachusetts
Vaccinated:2007-01-22
Onset:2007-01-22
Submitted:2007-02-14
Entered:2007-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - - / IM

Administered by: Other      Purchased by: Other
Symptoms: 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': WAES0702USA00129

Write-up:Information has been received from a physician concerning a female patient who in "the week of 22-JAN-2007" was vaccinated IM with a 0.5 ml dose of HPV vaccine (yeast). After vaccination, the patient fainted. Unspecified medical attention was sought. Subsequently, the patient recovered. No product quality complaint was involved. Additional information has been requested.


Changed on 3/2/2010

272614 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:Massachusetts
Vaccinated:2007-01-22 2007-03-07
Onset:2007-01-22 2007-03-11
Submitted:2007-02-14
Entered:2007-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - 0188U / - 1 - LA / IM

Administered by: Other      Purchased by: Other
Symptoms: 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': WAES0702USA00129

Write-up:Information has been received from a physician concerning a female patient who in "the week of 22-JAN-2007" was vaccinated IM with a 0.5 ml dose of HPV vaccine (yeast). After vaccination, the patient fainted. Unspecified medical attention was sought. Subsequently, the patient recovered. No product quality complaint was involved. Additional information has been requested. 07/06/07 This is in follow-up to report(s) previously submitted 02/14/2007. Information has been received from a physician and a nurse concerning a 15 year old female patient who on 07-MAR-2007, at 2:10, (previously reported as approximately 22-JAN-2007) was vaccinated IM, left deltoid, with a 0.5 ml dose of GARDASIL (lot # 657006/0188U). The patient reportedly had one prior dose of GARDASIL (date unknown). On 11-MAR-2007, late at night/early AM, the patient got up and on the way back to bed, she felt numbness and tingling in her legs then "blacked out for a few minutes". The patient said a friend woke her up. She felt tired all day. Later that afternoon, the patient went to her room, she didn''t feel right. She complained of tingling and numbness in her legs and arms, which lasted 5-10 minutes. Subsequently, the patient recoverd from her symptoms. No product quality complaint was involved. Additional information is not expected.


Changed on 4/7/2010

272614 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:Massachusetts
Vaccinated:2007-03-07
Onset:2007-03-11
Submitted:2007-02-14
Entered:2007-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0188U / 1 LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Fatigue, Hypoaesthesia, Loss of consciousness, Paraesthesia, 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': WAES0702USA00129

Write-up:Information has been received from a physician concerning a female patient who in "the week of 22-JAN-2007" was vaccinated IM with a 0.5 ml dose of HPV vaccine (yeast). After vaccination, the patient fainted. Unspecified medical attention was sought. Subsequently, the patient recovered. No product quality complaint was involved. Additional information has been requested. 07/06/07 This is in follow-up to report(s) previously submitted 02/14/2007. Information has been received from a physician and a nurse concerning a 15 year old female patient who on 07-MAR-2007, at 2:10, (previously reported as approximately 22-JAN-2007) was vaccinated IM, left deltoid, with a 0.5 ml dose of GARDASIL (lot # 657006/0188U). The patient reportedly had one prior dose of GARDASIL (date unknown). On 11-MAR-2007, late at night/early AM, the patient got up and on the way back to bed, she felt numbness and tingling in her legs then "blacked out for a few minutes". The patient said a friend woke her up. She felt tired all day. Later that afternoon, the patient went to her room, she didn''t feel right. She complained of tingling and numbness in her legs and arms, which lasted 5-10 minutes. Subsequently, the patient recoverd from her symptoms. No product quality complaint was involved. Additional information is not expected.


Changed on 6/14/2014

272614 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:Massachusetts
Vaccinated:2007-03-07
Onset:2007-03-11
Submitted:2007-02-14
Entered:2007-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0188U / 1 LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Fatigue, Hypoaesthesia, Loss of consciousness, Paraesthesia, 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': WAES0702USA00129

Write-up:Information has been received from a physician concerning a female patient who in "the week of 22-JAN-2007" was vaccinated IM with a 0.5 ml dose of HPV vaccine (yeast). After vaccination, the patient fainted. Unspecified medical attention was sought. Subsequently, the patient recovered. No product quality complaint was involved. Additional information has been requested. 07/06/07 This is in follow-up to report(s) previously submitted 02/14/2007. Information has been received from a physician and a nurse concerning a 15 year old female patient who on 07-MAR-2007, at 2:10, (previously reported as approximately 22-JAN-2007) was vaccinated IM, left deltoid, with a 0.5 ml dose of GARDASIL (lot # 657006/0188U). The patient reportedly had one prior dose of GARDASIL (date unknown). On 11-MAR-2007, late at night/early AM, the patient got up and on the way back to bed, she felt numbness and tingling in her legs then "blacked out for a few minutes". The patient said a friend woke her up. She felt tired all day. Later that afternoon, the patient went to her room, she didn''t feel right. She complained of tingling and numbness in her legs and arms, which lasted 5-10 minutes. Subsequently, the patient recoverd from her symptoms. No product quality complaint was involved. Additional information is not expected.


Changed on 5/14/2017

272614 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:Massachusetts
Vaccinated:2007-03-07
Onset:2007-03-11
Submitted:2007-02-14
Entered:2007-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0188U / 1 LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Fatigue, Hypoaesthesia, Loss of consciousness, Paraesthesia, 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': WAES0702USA00129

Write-up:Information has been received from a physician concerning a female patient who in "the week of 22-JAN-2007" was vaccinated IM with a 0.5 ml dose of HPV vaccine (yeast). After vaccination, the patient fainted. Unspecified medical attention was sought. Subsequently, the patient recovered. No product quality complaint was involved. Additional information has been requested. 07/06/07 This is in follow-up to report(s) previously submitted 02/14/2007. Information has been received from a physician and a nurse concerning a 15 year old female patient who on 07-MAR-2007, at 2:10, (previously reported as approximately 22-JAN-2007) was vaccinated IM, left deltoid, with a 0.5 ml dose of GARDASIL (lot # 657006/0188U). The patient reportedly had one prior dose of GARDASIL (date unknown). On 11-MAR-2007, late at night/early AM, the patient got up and on the way back to bed, she felt numbness and tingling in her legs then "blacked out for a few minutes". The patient said a friend woke her up. She felt tired all day. Later that afternoon, the patient went to her room, she didn''t feel right. She complained of tingling and numbness in her legs and arms, which lasted 5-10 minutes. Subsequently, the patient recoverd from her symptoms. No product quality complaint was involved. Additional information is not expected.


Changed on 9/14/2017

272614 Before After
VAERS Form:(blank) 1
Age:15.0
Gender:Female
Location:Massachusetts
Vaccinated:2007-03-07
Onset:2007-03-11
Submitted:2007-02-14
Entered:2007-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0188U / 1 2 LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Fatigue, Hypoaesthesia, Loss of consciousness, Paraesthesia, 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': WAES0702USA00129

Write-up:Information has been received from a physician concerning a female patient who in "the week of 22-JAN-2007" was vaccinated IM with a 0.5 ml dose of HPV vaccine (yeast). After vaccination, the patient fainted. Unspecified medical attention was sought. Subsequently, the patient recovered. No product quality complaint was involved. Additional information has been requested. 07/06/07 This is in follow-up to report(s) previously submitted 02/14/2007. Information has been received from a physician and a nurse concerning a 15 year old female patient who on 07-MAR-2007, at 2:10, (previously reported as approximately 22-JAN-2007) was vaccinated IM, left deltoid, with a 0.5 ml dose of GARDASIL (lot # 657006/0188U). The patient reportedly had one prior dose of GARDASIL (date unknown). On 11-MAR-2007, late at night/early AM, the patient got up and on the way back to bed, she felt numbness and tingling in her legs then "blacked out for a few minutes". The patient said a friend woke her up. She felt tired all day. Later that afternoon, the patient went to her room, she didn''t feel right. She complained of tingling and numbness in her legs and arms, which lasted 5-10 minutes. Subsequently, the patient recoverd from her symptoms. No product quality complaint was involved. Additional information is not expected.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=272614&WAYBACKHISTORY=ON


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