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This is VAERS ID 274294

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

274294
VAERS Form:
Age:12.0
Gender:Female
Location:California
Vaccinated:2007-02-12
Onset:2007-02-12
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Syncope

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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 physician concerning a 12 year female who on approximately 12-FEB-2007 was vaccinated intramuscularly with a dose of Gardasil. On approximately 12-FEB-2006 the patient fainted after the administration of Gardasil. Unsp"ecified medical attention was sought. At the time of the report, the patient''''s outcome was unknown. Additional information has been requested.


Changed on 12/8/2009

274294 Before After
VAERS Form:
Age:12.0
Gender:Female
Location:California
Vaccinated:2007-02-12
Onset:2007-02-12
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Syncope

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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) WAES0702USA03444

Write-up:Information has been received from a physician concerning a 12 year female who on approximately 12-FEB-2007 was vaccinated intramuscularly with a dose of Gardasil. On approximately 12-FEB-2006 the patient fainted after the administration of Gardasil. Unsp"ecified Unspecified medical attention was sought. At the time of the report, the patient''''s patient''s outcome was unknown. Additional information has been requested.


Changed on 9/14/2017

274294 Before After
VAERS Form:(blank) 1
Age:12.0
Gender:Female
Location:California
Vaccinated:2007-02-12
Onset:2007-02-12
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UNK - / IM

Administered by: Other      Purchased by: Other
Symptoms: Syncope

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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': WAES0702USA03444

Write-up:Information has been received from a physician concerning a 12 year female who on approximately 12-FEB-2007 was vaccinated intramuscularly with a dose of Gardasil. On approximately 12-FEB-2006 the patient fainted after the administration of Gardasil. Unspecified medical attention was sought. At the time of the report, the patient''s outcome was unknown. Additional information has been requested.


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Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=274294&WAYBACKHISTORY=ON


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