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This is VAERS ID 273916

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

273916
VAERS Form:
Age:16.0
Gender:Female
Location:North Dakota
Vaccinated:2006-08-31
Onset:2006-08-31
Submitted:2007-03-08
Entered:2007-03-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0640F / 0 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: 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)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CT- brain - normal
CDC 'Split Type':

Write-up:Patient walked to lobby after shot and passed out, then body shook. She was helped back to exam room and observed. She hit back of head and no bump forward. Iced area for 30 minutes. She left in 45 minutes in good condition. Ct scan normal next day.


Changed on 12/8/2009

273916 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:North Dakota
Vaccinated:2006-08-31
Onset:2006-08-31
Submitted:2007-03-08
Entered:2007-03-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0640F / 0 LA / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: 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)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CT- brain - normal
CDC 'Split Type':

Write-up:Patient walked to lobby after shot and passed out, then body shook. She was helped back to exam room and observed. She hit back of head and no bump forward. Iced area for 30 minutes. She left in 45 minutes in good condition. Ct scan normal next day.


Changed on 9/14/2017

273916 Before After
VAERS Form:(blank) 1
Age:16.0
Gender:Female
Location:North Dakota
Vaccinated:2006-08-31
Onset:2006-08-31
Submitted:2007-03-08
Entered:2007-03-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0640F / 0 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: 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)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CT- brain - normal
CDC 'Split Type':

Write-up:Patient walked to lobby after shot and passed out, then body shook. She was helped back to exam room and observed. She hit back of head and no bump forward. Iced area for 30 minutes. She left in 45 minutes in good condition. Ct scan normal next day.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=273916&WAYBACKHISTORY=ON


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