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This is VAERS ID 274120

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

274120
VAERS Form:
Age:24.0
Gender:Female
Location:Illinois
Vaccinated:2006-11-21
Onset:2006-11-21
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0954F / 0 - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Influenza, Insomnia

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: Inderal
Current Illness: Syncope
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type':

Write-up:Information has been received from a Certified Medical Assistant concerning a 24 year old female patient with neurocardiogenic syncope who on 21-NOV-2006 was vaccinated IM with her first dose of Gardasil, lot #653938/0954F. Concomitant therapy included IN"DERAL. on 21-NOV-2006 the patient experienced insomnia for one month following the administration of Gardasil. She later had the flu from being run down and lack of sleep. Unspecified medical attention was sought. The patient was reported as recovered. Ad


Changed on 12/8/2009

274120 Before After
VAERS Form:
Age:24.0
Gender:Female
Location:Illinois
Vaccinated:2006-11-21
Onset:2006-11-21
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0954F / 0 - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Influenza, Insomnia

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: Inderal
Current Illness: Syncope
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': (blank) WAES0702USA00593

Write-up:Information has been received from a Certified Medical Assistant concerning a 24 year old female patient with neurocardiogenic syncope who on 21-NOV-2006 was vaccinated IM with her first dose of Gardasil, lot #653938/0954F. Concomitant therapy included IN"DERAL. on INDERAL. On 21-NOV-2006 the patient experienced insomnia for one month following the administration of Gardasil. She later had the flu from being run down and lack of sleep. Unspecified medical attention was sought. The patient was reported as recovered. Ad Additional information has been requested.


Changed on 3/2/2010

274120 Before After
VAERS Form:
Age:24.0
Gender:Female
Location:Illinois
Vaccinated:2006-11-21
Onset:2006-11-21
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0954F / 0 - UN / IM

Administered by: Other Private      Purchased by: Other
Symptoms: Influenza, Insomnia

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: Inderal
Current Illness: Syncope
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK Unknown
CDC 'Split Type': WAES0702USA00593

Write-up:This is in follow-up to report(s) previously submitted on 3/14/2007. Information has been received from a Certified Medical Assistant concerning a 24 year old female patient with neurocardiogenic syncope who on 21-NOV-2006 was vaccinated IM with her first dose of Gardasil, lot #653938/0954F. Concomitant therapy included INDERAL. On 21-NOV-2006 the patient experienced insomnia for one month following the administration of Gardasil. She later had the flu from being run down and lack of sleep. The patient desired a prescription for sleep after her next injection. Unspecified medical attention was sought. The patient was reported as recovered. Additional information has been requested. is not expected.


Changed on 4/7/2010

274120 Before After
VAERS Form:
Age:24.0
Gender:Female
Location:Illinois
Vaccinated:2006-11-21
Onset:2006-11-21
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0954F / 0 UN / IM

Administered by: Private      Purchased by: Other
Symptoms: Fatigue, Influenza, Insomnia

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: Inderal
Current Illness: Syncope
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0702USA00593

Write-up:This is in follow-up to report(s) previously submitted on 3/14/2007. Information has been received from a Certified Medical Assistant concerning a 24 year old female patient with neurocardiogenic syncope who on 21-NOV-2006 was vaccinated IM with her first dose of Gardasil, lot #653938/0954F. Concomitant therapy included INDERAL. On 21-NOV-2006 the patient experienced insomnia for one month following the administration of Gardasil. She later had the flu from being run down and lack of sleep. The patient desired a prescription for sleep after her next injection. Unspecified medical attention was sought. The patient was reported as recovered. Additional information is not expected.


Changed on 6/14/2014

274120 Before After
VAERS Form:
Age:24.0
Gender:Female
Location:Illinois
Vaccinated:2006-11-21
Onset:2006-11-21
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0954F / 0 UN / IM

Administered by: Private      Purchased by: Other
Symptoms: Fatigue, Influenza, Insomnia

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: Inderal
Current Illness: Syncope
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0702USA00593

Write-up:This is in follow-up to report(s) previously submitted on 3/14/2007. Information has been received from a Certified Medical Assistant concerning a 24 year old female patient with neurocardiogenic syncope who on 21-NOV-2006 was vaccinated IM with her first dose of Gardasil, lot #653938/0954F. Concomitant therapy included INDERAL. On 21-NOV-2006 the patient experienced insomnia for one month following the administration of Gardasil. She later had the flu from being run down and lack of sleep. The patient desired a prescription for sleep after her next injection. Unspecified medical attention was sought. The patient was reported as recovered. Additional information is not expected.


Changed on 5/14/2017

274120 Before After
VAERS Form:
Age:24.0
Gender:Female
Location:Illinois
Vaccinated:2006-11-21
Onset:2006-11-21
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0954F / 0 UN / IM

Administered by: Private      Purchased by: Other
Symptoms: Fatigue, Influenza, Insomnia

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: Inderal
Current Illness: Syncope
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0702USA00593

Write-up:This is in follow-up to report(s) previously submitted on 3/14/2007. Information has been received from a Certified Medical Assistant concerning a 24 year old female patient with neurocardiogenic syncope who on 21-NOV-2006 was vaccinated IM with her first dose of Gardasil, lot #653938/0954F. Concomitant therapy included INDERAL. On 21-NOV-2006 the patient experienced insomnia for one month following the administration of Gardasil. She later had the flu from being run down and lack of sleep. The patient desired a prescription for sleep after her next injection. Unspecified medical attention was sought. The patient was reported as recovered. Additional information is not expected.


Changed on 9/14/2017

274120 Before After
VAERS Form:(blank) 1
Age:24.0
Gender:Female
Location:Illinois
Vaccinated:2006-11-21
Onset:2006-11-21
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0954F / 0 1 UN / IM

Administered by: Private      Purchased by: Other
Symptoms: Fatigue, Influenza, Insomnia

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: Inderal
Current Illness: Syncope
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0702USA00593

Write-up:This is in follow-up to report(s) previously submitted on 3/14/2007. Information has been received from a Certified Medical Assistant concerning a 24 year old female patient with neurocardiogenic syncope who on 21-NOV-2006 was vaccinated IM with her first dose of Gardasil, lot #653938/0954F. Concomitant therapy included INDERAL. On 21-NOV-2006 the patient experienced insomnia for one month following the administration of Gardasil. She later had the flu from being run down and lack of sleep. The patient desired a prescription for sleep after her next injection. Unspecified medical attention was sought. The patient was reported as recovered. Additional information is not expected.


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