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This is VAERS ID 274277

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

274277
VAERS Form:
Age:25.0
Gender:Female
Location:Florida
Vaccinated:2007-02-02
Onset:2007-02-02
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0012U / 0 - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Eating disorder, Loss of consciousness, 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: Depo-Provera
Current Illness: Flu Symptoms
Preexisting Conditions: Immunisation
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type':

Write-up:Information has been received from a nurse concerning a 25 year old female who on 02-FEB-2007 was vaccinated IM with a first 0.5 ml dose of Gardasil (lot #655503/012U). Concomitant therapy included Depo-Provera. Illness at the time of vaccination included"flu-like symptoms. Immediately after vaccination, the patient had syncope and passed out for approximately one minute. It was also noted that her eating was sporatic. The patient has not passed out with previous injections in the past. The physician did n


Changed on 12/8/2009

274277 Before After
VAERS Form:
Age:25.0
Gender:Female
Location:Florida
Vaccinated:2007-02-02
Onset:2007-02-02
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0012U / 0 - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Eating disorder, Loss of consciousness, 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: Depo-Provera
Current Illness: Flu Symptoms
Preexisting Conditions: Immunisation
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': (blank) WAES0702USA02941

Write-up:Information has been received from a nurse concerning a 25 year old female who on 02-FEB-2007 was vaccinated IM with a first 0.5 ml dose of Gardasil (lot #655503/012U). Concomitant therapy included Depo-Provera. Illness at the time of vaccination included"flu-like included flu-like symptoms. Immediately after vaccination, the patient had syncope and passed out for approximately one minute. It was also noted that her eating was sporatic. The patient has not passed out with previous injections in the past. The physician did n not believe the injection cause the syncope. Unspecified medical attention was sought. On 02-FEB-2007, the patient recovered. No product quality complaint was involved. Additional information has been requested.


Changed on 3/2/2010

274277 Before After
VAERS Form:
Age:25.0
Gender:Female
Location:Florida
Vaccinated:2007-02-02
Onset:2007-02-02
Submitted:2007-03-14 2007-10-08
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0012U / 0 - / IM

Administered by: Other Private      Purchased by: Other Private
Symptoms: Eating disorder, Loss of consciousness, 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: Depo-Provera
Current Illness: Flu Symptoms Symptoms; cold symptoms
Preexisting Conditions: Immunisation
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0702USA02941

Write-up:Information has been received from a nurse concerning a 25 year old female who on 02-FEB-2007 was vaccinated IM with a first 0.5 ml dose of Gardasil GARDASIL vaccine (yeast) (lot #655503/012U). Concomitant therapy included Depo-Provera. DEPO-PROVERA. Illness at the time of vaccination included flu-like symptoms. Immediately after vaccination, the patient had syncope and passed out for approximately one minute. It was also noted that her eating was sporatic. The patient has not passed out with previous injections in the past. The physician did not believe the injection cause the syncope. Unspecified medical attention was sought. On 02-FEB-2007, the patient recovered. No product quality complaint was involved. Additional information has been requested. This is in follow-up to report(s) previously submitted on 3/14/2007 Information has been received from a nurse concerning a 25 year old female child care provider with no known drug allergies who on 02-FEB-2007 was vaccinated IM with a fiest dose 0.5 ml dose of GARDASIL vaccine (yeast) (lot # 655503/0012U). Concomitant therapy included DEPO-PROVERA . Illness at the time of vaccination included common cold-type symptoms. Immediately after vaccination , the patient had syncope and passed out for approximately one minute. It was also noted that her eating was sporatic. The patient had not passed out with previous injections u=in the past. The physician did not believe the injection cause the syncope. Unspecified medical attention was sought. On 02-FEB-2007, the patient recovered. No product quality complaint was involved. Additional information is not expected.


Changed on 4/7/2010

274277 Before After
VAERS Form:
Age:25.0
Gender:Female
Location:Florida
Vaccinated:2007-02-02
Onset:2007-02-02
Submitted:2007-10-08
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0012U / 0 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Eating disorder, Loss of consciousness, Syncope, Immediate post-injection reaction

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: Depo-Provera
Current Illness: Flu Symptoms; cold symptoms
Preexisting Conditions: Immunisation
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0702USA02941

Write-up:Information has been received from a nurse concerning a 25 year old female who on 02-FEB-2007 was vaccinated IM with a first 0.5 ml dose of GARDASIL vaccine (yeast) (lot #655503/012U). Concomitant therapy included DEPO-PROVERA. Illness at the time of vaccination included flu-like symptoms. Immediately after vaccination, the patient had syncope and passed out for approximately one minute. It was also noted that her eating was sporatic. The patient has not passed out with previous injections in the past. The physician did not believe the injection cause the syncope. Unspecified medical attention was sought. On 02-FEB-2007, the patient recovered. No product quality complaint was involved. Additional information has been requested. This is in follow-up to report(s) previously submitted on 3/14/2007 Information has been received from a nurse concerning a 25 year old female child care provider with no known drug allergies who on 02-FEB-2007 was vaccinated IM with a fiest dose 0.5 ml dose of GARDASIL vaccine (yeast) (lot # 655503/0012U). Concomitant therapy included DEPO-PROVERA . Illness at the time of vaccination included common cold-type symptoms. Immediately after vaccination , the patient had syncope and passed out for approximately one minute. It was also noted that her eating was sporatic. The patient had not passed out with previous injections u=in the past. The physician did not believe the injection cause the syncope. Unspecified medical attention was sought. On 02-FEB-2007, the patient recovered. No product quality complaint was involved. Additional information is not expected.


Changed on 6/14/2014

274277 Before After
VAERS Form:
Age:25.0
Gender:Female
Location:Florida
Vaccinated:2007-02-02
Onset:2007-02-02
Submitted:2007-10-08
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0012U / 0 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Eating disorder, Loss of consciousness, Syncope, Immediate post-injection reaction

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: Depo-Provera
Current Illness: Flu Symptoms; cold symptoms
Preexisting Conditions: Immunisation
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0702USA02941

Write-up:Information has been received from a nurse concerning a 25 year old female who on 02-FEB-2007 was vaccinated IM with a first 0.5 ml dose of GARDASIL vaccine (yeast) (lot #655503/012U). Concomitant therapy included DEPO-PROVERA. Illness at the time of vaccination included flu-like symptoms. Immediately after vaccination, the patient had syncope and passed out for approximately one minute. It was also noted that her eating was sporatic. The patient has not passed out with previous injections in the past. The physician did not believe the injection cause the syncope. Unspecified medical attention was sought. On 02-FEB-2007, the patient recovered. No product quality complaint was involved. Additional information has been requested. This is in follow-up to report(s) previously submitted on 3/14/2007 Information has been received from a nurse concerning a 25 year old female child care provider with no known drug allergies who on 02-FEB-2007 was vaccinated IM with a fiest dose 0.5 ml dose of GARDASIL vaccine (yeast) (lot # 655503/0012U). Concomitant therapy included DEPO-PROVERA . Illness at the time of vaccination included common cold-type symptoms. Immediately after vaccination , the patient had syncope and passed out for approximately one minute. It was also noted that her eating was sporatic. The patient had not passed out with previous injections u=in the past. The physician did not believe the injection cause the syncope. Unspecified medical attention was sought. On 02-FEB-2007, the patient recovered. No product quality complaint was involved. Additional information is not expected.


Changed on 5/14/2017

274277 Before After
VAERS Form:
Age:25.0
Gender:Female
Location:Florida
Vaccinated:2007-02-02
Onset:2007-02-02
Submitted:2007-10-08
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0012U / 0 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Eating disorder, Loss of consciousness, Syncope, Immediate post-injection reaction

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: Depo-Provera
Current Illness: Flu Symptoms; cold symptoms
Preexisting Conditions: Immunisation
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0702USA02941

Write-up:Information has been received from a nurse concerning a 25 year old female who on 02-FEB-2007 was vaccinated IM with a first 0.5 ml dose of GARDASIL vaccine (yeast) (lot #655503/012U). Concomitant therapy included DEPO-PROVERA. Illness at the time of vaccination included flu-like symptoms. Immediately after vaccination, the patient had syncope and passed out for approximately one minute. It was also noted that her eating was sporatic. The patient has not passed out with previous injections in the past. The physician did not believe the injection cause the syncope. Unspecified medical attention was sought. On 02-FEB-2007, the patient recovered. No product quality complaint was involved. Additional information has been requested. This is in follow-up to report(s) previously submitted on 3/14/2007 Information has been received from a nurse concerning a 25 year old female child care provider with no known drug allergies who on 02-FEB-2007 was vaccinated IM with a fiest dose 0.5 ml dose of GARDASIL vaccine (yeast) (lot # 655503/0012U). Concomitant therapy included DEPO-PROVERA . Illness at the time of vaccination included common cold-type symptoms. Immediately after vaccination , the patient had syncope and passed out for approximately one minute. It was also noted that her eating was sporatic. The patient had not passed out with previous injections u=in the past. The physician did not believe the injection cause the syncope. Unspecified medical attention was sought. On 02-FEB-2007, the patient recovered. No product quality complaint was involved. Additional information is not expected.


Changed on 9/14/2017

274277 Before After
VAERS Form:(blank) 1
Age:25.0
Gender:Female
Location:Florida
Vaccinated:2007-02-02
Onset:2007-02-02
Submitted:2007-10-08
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0012U / 0 1 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Eating disorder, Loss of consciousness, Syncope, Immediate post-injection reaction

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: Depo-Provera
Current Illness: Flu Symptoms; cold symptoms
Preexisting Conditions: Immunisation
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0702USA02941

Write-up:Information has been received from a nurse concerning a 25 year old female who on 02-FEB-2007 was vaccinated IM with a first 0.5 ml dose of GARDASIL vaccine (yeast) (lot #655503/012U). Concomitant therapy included DEPO-PROVERA. Illness at the time of vaccination included flu-like symptoms. Immediately after vaccination, the patient had syncope and passed out for approximately one minute. It was also noted that her eating was sporatic. The patient has not passed out with previous injections in the past. The physician did not believe the injection cause the syncope. Unspecified medical attention was sought. On 02-FEB-2007, the patient recovered. No product quality complaint was involved. Additional information has been requested. This is in follow-up to report(s) previously submitted on 3/14/2007 Information has been received from a nurse concerning a 25 year old female child care provider with no known drug allergies who on 02-FEB-2007 was vaccinated IM with a fiest dose 0.5 ml dose of GARDASIL vaccine (yeast) (lot # 655503/0012U). Concomitant therapy included DEPO-PROVERA . Illness at the time of vaccination included common cold-type symptoms. Immediately after vaccination , the patient had syncope and passed out for approximately one minute. It was also noted that her eating was sporatic. The patient had not passed out with previous injections u=in the past. The physician did not believe the injection cause the syncope. Unspecified medical attention was sought. On 02-FEB-2007, the patient recovered. No product quality complaint was involved. Additional information is not expected.


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