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This is VAERS ID 274084

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 274084
Age:13.0
Gender:Female
Location:Florida
Vaccinated:2007-02-19
Onset:2007-02-19
Submitted:2007-03-11
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - - / -
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR - / - - / -
VARCEL: VARICELLA (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Laceration, Oxygen saturation, Syncope, Tooth repair

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: PO2 99%
CDC 'Split Type':

Write-up:2-19-07 child had well check up, received vaccines of Gardasil, Hep A, Menactra, Varicella. Approx at 3:00pm had syncopal episode on the way out of the office. First aid rendered for lip laceration. B/P and vital signs checked, reverse trendelenburg posit"ion. Sent to dental office for tooth repair.


Changed on 12/8/2009

VAERS ID: 274084 Before After
Age:13.0
Gender:Female
Location:Florida
Vaccinated:2007-02-19
Onset:2007-02-19
Submitted:2007-03-11
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - - / -
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR - / - - / -
VARCEL: VARICELLA (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: Private      Purchased by: Unknown Private
Symptoms: Laceration, Oxygen saturation, Syncope, Tooth repair

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: PO2 99%
CDC 'Split Type':

Write-up:2-19-07 child had well check up, received vaccines of Gardasil, Hep A, Menactra, Varicella. Approx at 3:00pm had syncopal episode on the way out of the office. First aid rendered for lip laceration. B/P and vital signs checked, reverse trendelenburg posit"ion. position. Sent to dental office for tooth repair.


Changed on 3/2/2010

VAERS ID: 274084 Before After
Age:13.0
Gender:Female
Location:Florida
Vaccinated:2007-02-19
Onset:2007-02-19
Submitted:2007-03-11
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (NO BRAND NAME) HEP A (HAVRIX) / UNKNOWN MANUFACTURER GLAXOSMITHKLINE BIOLOGICALS - AHAVB19AA / - - UN / - UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - 001N / - - UN / - UN
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR SANOFI PASTEUR - U1968AA / - - UN / - UN
VARCEL: VARICELLA (NO BRAND NAME) VARICELLA (VARIVAX) / UNKNOWN MANUFACTURER MERCK & CO. INC. - 1497F / - - UN / - UN

Administered by: Private      Purchased by: Private
Symptoms: Laceration, Oxygen saturation, Syncope, Tooth repair

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: PO2 99%
CDC 'Split Type':

Write-up:2-19-07 child had well check up, received vaccines of Gardasil, Hep A, Menactra, Varicella. Approx at 3:00pm had syncopal episode on the way out of the office. First aid rendered for lip laceration. B/P and vital signs checked, reverse trendelenburg position. Sent to dental office for tooth repair.


Changed on 4/7/2010

VAERS ID: 274084 Before After
Age:13.0
Gender:Female
Location:Florida
Vaccinated:2007-02-19
Onset:2007-02-19
Submitted:2007-03-11
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB19AA / - UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 001N / - UN / UN
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1968AA / - UN / UN
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1497F / - UN / UN

Administered by: Private      Purchased by: Private
Symptoms: Laceration, Oxygen saturation, Syncope, Tooth repair

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: PO2 99%
CDC 'Split Type':

Write-up:2-19-07 child had well check up, received vaccines of Gardasil, Hep A, Menactra, Varicella. Approx at 3:00pm had syncopal episode on the way out of the office. First aid rendered for lip laceration. B/P and vital signs checked, reverse trendelenburg position. Sent to dental office for tooth repair.


Changed on 6/14/2014

VAERS ID: 274084 Before After
Age:13.0
Gender:Female
Location:Florida
Vaccinated:2007-02-19
Onset:2007-02-19
Submitted:2007-03-11
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB19AA / - UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 001N / - UN / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1968AA / - UN / UN
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1497F / - UN / UN

Administered by: Private      Purchased by: Private
Symptoms: Laceration, Oxygen saturation, Syncope, Tooth repair

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: PO2 99%
CDC 'Split Type':

Write-up:2-19-07 child had well check up, received vaccines of Gardasil, Hep A, Menactra, Varicella. Approx at 3:00pm had syncopal episode on the way out of the office. First aid rendered for lip laceration. B/P and vital signs checked, reverse trendelenburg position. Sent to dental office for tooth repair.


Changed on 5/14/2017

VAERS ID: 274084 Before After
Age:13.0
Gender:Female
Location:Florida
Vaccinated:2007-02-19
Onset:2007-02-19
Submitted:2007-03-11
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB19AA / - UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 001N / - UN / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1968AA / - UN / UN
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1497F / - UN / UN

Administered by: Private      Purchased by: Private
Symptoms: Laceration, Oxygen saturation, Syncope, Tooth repair

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: PO2 99%
CDC 'Split Type':

Write-up:2-19-07 child had well check up, received vaccines of Gardasil, Hep A, Menactra, Varicella. Approx at 3:00pm had syncopal episode on the way out of the office. First aid rendered for lip laceration. B/P and vital signs checked, reverse trendelenburg position. Sent to dental office for tooth repair.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=274084&WAYBACKHISTORY=ON


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