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This is VAERS ID 274194

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

274194
VAERS Form:
Age:
Gender:Female
Location:Connecticut
Vaccinated:2007-01-31
Onset:2007-01-31
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - - / -
MEN: MENINGOCOCCAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: Other      Purchased by: Unknown
Symptoms: Dizziness, Injection site pain, Sudden hearing loss

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 registered nurse, via a company representative, concerning a female who on approximately 31 Jan 2007 was vaccinated with a dose of Gardasil in one arm and possibly a meningococcal vaccine (unspecified) in the other arm". Subsequently the patient felt faint, experienced a temporary loss of hearing, and also experienced pain from the injection. The nurse indicated that the patient''''s /"fair hair (red or blonde) made them more susceptible to the adverse events./" The patie


Changed on 12/8/2009

274194 Before After
VAERS Form:
Age:
Gender:Female
Location:Connecticut
Vaccinated:2007-01-31
Onset:2007-01-31
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - - / -
MEN: MENINGOCOCCAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Dizziness, Injection site pain, Sudden hearing loss

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) WAES0702USA01291

Write-up:Information has been received from a registered nurse, via a company representative, concerning a female who on approximately 31 Jan 2007 was vaccinated with a dose of Gardasil in one arm and possibly a meningococcal vaccine (unspecified) in the other arm". arm. Subsequently the patient felt faint, experienced a temporary loss of hearing, and also experienced pain from the injection. The nurse indicated that the patient''''s /"fair patient''s "fair hair (red or blonde) made them more susceptible to the adverse events./" events." The patie patient was observed in the office and after a short time recovered and left. Additional information has been requested.


Changed on 9/14/2017

274194 Before After
VAERS Form:(blank) 1
Age:
Gender:Female
Location:Connecticut
Vaccinated:2007-01-31
Onset:2007-01-31
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UNK - / -
MEN: MENINGOCOCCAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Dizziness, Injection site pain, Sudden hearing loss

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': WAES0702USA01291

Write-up:Information has been received from a registered nurse, via a company representative, concerning a female who on approximately 31 Jan 2007 was vaccinated with a dose of Gardasil in one arm and possibly a meningococcal vaccine (unspecified) in the other arm. Subsequently the patient felt faint, experienced a temporary loss of hearing, and also experienced pain from the injection. The nurse indicated that the patient''s "fair hair (red or blonde) made them more susceptible to the adverse events." The patient was observed in the office and after a short time recovered and left. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=274194&WAYBACKHISTORY=ON


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