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This is VAERS ID 274590

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

274590
VAERS Form:
Age:
Gender:Female
Location:Michigan
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - - / -

Administered by: Other      Purchased by: Unknown
Symptoms: 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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type':

Write-up:Information has been received from a physician concerning her daughter who was vaccinated with a dose of HPV during her Christmas holiday break from college. After the vaccination, the patient walked to the reception desk and fainted. The patient awoke by"herself. Unspecified medical attention was sought. It was reported that the patient was embarrassed, then walked out to the car with her parents. Subsequently, the patient recovered. Additional information has been requested.


Changed on 12/8/2009

274590 Before After
VAERS Form:
Age:
Gender:Female
Location:Michigan
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - - / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: 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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': (blank) WAES0702USA04082

Write-up:Information has been received from a physician concerning her daughter who was vaccinated with a dose of HPV during her Christmas holiday break from college. After the vaccination, the patient walked to the reception desk and fainted. The patient awoke by"herself. by herself. Unspecified medical attention was sought. It was reported that the patient was embarrassed, then walked out to the car with her parents. Subsequently, the patient recovered. Additional information has been requested.


Changed on 3/2/2010

274590 Before After
VAERS Form:
Age:(blank) 2.0
Gender:Female
Location:Michigan
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - - UN / - UN

Administered by: Other      Purchased by: Other
Symptoms: 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: UNK Unknown
Current Illness:
Preexisting Conditions: UNK Unknown
Allergies:
Diagnostic Lab Data: UNK None
CDC 'Split Type': WAES0702USA04082

Write-up:Information has been received from a physician concerning her daughter who was vaccinated with a dose of HPV during her Christmas holiday break from college. After the vaccination, the patient walked to the reception desk and fainted. The patient awoke by herself. Unspecified medical attention was sought. It was reported that the patient was embarrassed, then walked out to the car with her parents. Subsequently, the patient recovered. Additional information has been requested. This is in follow-up to report (s) previously submitted on 3/14/2007. Initial and follow-up information has been received from two physicians concerning their daughter, a 22 year old female with ulcerative colitis (in remission) who on 03-JAN-2007, at 3:00 pm, was vaccinated intramuscularly into the right deltoid with the first dose of GARDASIL (Lot # 659978/0955F), during her holiday break from college. The physician reported that on 03-JAN-2007, at 3:15 pm, the patient experienced vaso-vagal faint. The patient awoke by herself. Unspecified medical attention was sought. Subsequently, the patient recovered from vaso-vagal faint. It was reported that the patient was embarrassed, then walked out to the care with her parents. Additional information is not expected.


Changed on 4/7/2010

274590 Before After
VAERS Form:
Age:2.0 22.0
Gender:Female
Location:Michigan
Vaccinated:0000-00-00 2007-01-03
Onset:0000-00-00 2007-01-03
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - 0955F / - 0 UN RA / UN IM

Administered by: Other      Purchased by: Other
Symptoms:

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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0702USA04082

Write-up:Information has been received from a physician concerning her daughter who was vaccinated with a dose of HPV during her Christmas holiday break from college. After the vaccination, the patient walked to the reception desk and fainted. The patient awoke by herself. Unspecified medical attention was sought. It was reported that the patient was embarrassed, then walked out to the car with her parents. Subsequently, the patient recovered. Additional information has been requested. This is in follow-up to report (s) previously submitted on 3/14/2007. Initial and follow-up information has been received from two physicians concerning their daughter, a 22 year old female with ulcerative colitis (in remission) who on 03-JAN-2007, at 3:00 pm, was vaccinated intramuscularly into the right deltoid with the first dose of GARDASIL (Lot # 659978/0955F), during her holiday break from college. The physician reported that on 03-JAN-2007, at 3:15 pm, the patient experienced vaso-vagal faint. The patient awoke by herself. Unspecified medical attention was sought. Subsequently, the patient recovered from vaso-vagal faint. It was reported that the patient was embarrassed, then walked out to the care with her parents. Additional information is not expected.


Changed on 7/31/2010

274590 Before After
VAERS Form:
Age:22.0
Gender:Female
Location:Michigan
Vaccinated:2007-01-03
Onset:2007-01-03
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 0 RA / IM

Administered by: Other      Purchased by: Other
Symptoms: 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0702USA04082

Write-up:Information has been received from a physician concerning her daughter who was vaccinated with a dose of HPV during her Christmas holiday break from college. After the vaccination, the patient walked to the reception desk and fainted. The patient awoke by herself. Unspecified medical attention was sought. It was reported that the patient was embarrassed, then walked out to the car with her parents. Subsequently, the patient recovered. Additional information has been requested. This is in follow-up to report (s) previously submitted on 3/14/2007. Initial and follow-up information has been received from two physicians concerning their daughter, a 22 year old female with ulcerative colitis (in remission) who on 03-JAN-2007, at 3:00 pm, was vaccinated intramuscularly into the right deltoid with the first dose of GARDASIL (Lot # 659978/0955F), during her holiday break from college. The physician reported that on 03-JAN-2007, at 3:15 pm, the patient experienced vaso-vagal faint. The patient awoke by herself. Unspecified medical attention was sought. Subsequently, the patient recovered from vaso-vagal faint. It was reported that the patient was embarrassed, then walked out to the care with her parents. Additional information is not expected.


Changed on 8/31/2010

274590 Before After
VAERS Form:
Age:22.0
Gender:Female
Location:Michigan
Vaccinated:2007-01-03
Onset:2007-01-03
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 0 RA / IM

Administered by: Other      Purchased by: Other
Symptoms: Syncope, Syncope vasovagal

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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0702USA04082

Write-up:Information has been received from a physician concerning her daughter who was vaccinated with a dose of HPV during her Christmas holiday break from college. After the vaccination, the patient walked to the reception desk and fainted. The patient awoke by herself. Unspecified medical attention was sought. It was reported that the patient was embarrassed, then walked out to the car with her parents. Subsequently, the patient recovered. Additional information has been requested. This is in follow-up to report (s) previously submitted on 3/14/2007. Initial and follow-up information has been received from two physicians concerning their daughter, a 22 year old female with ulcerative colitis (in remission) who on 03-JAN-2007, at 3:00 pm, was vaccinated intramuscularly into the right deltoid with the first dose of GARDASIL (Lot # 659978/0955F), during her holiday break from college. The physician reported that on 03-JAN-2007, at 3:15 pm, the patient experienced vaso-vagal faint. The patient awoke by herself. Unspecified medical attention was sought. Subsequently, the patient recovered from vaso-vagal faint. It was reported that the patient was embarrassed, then walked out to the care with her parents. Additional information is not expected.


Changed on 1/4/2011

274590 Before After
VAERS Form:
Age:22.0
Gender:Female
Location:Michigan
Vaccinated:2007-01-03
Onset:2007-01-03
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 0 RA / IM

Administered by: Other      Purchased by: Other
Symptoms: Syncope, Syncope vasovagal

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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0702USA04082

Write-up:Information has been received from a physician concerning her daughter who was vaccinated with a dose of HPV during her Christmas holiday break from college. After the vaccination, the patient walked to the reception desk and fainted. The patient awoke by herself. Unspecified medical attention was sought. It was reported that the patient was embarrassed, then walked out to the car with her parents. Subsequently, the patient recovered. Additional information has been requested. This is in follow-up to report (s) previously submitted on 3/14/2007. Initial and follow-up information has been received from two physicians concerning their daughter, a 22 year old female with ulcerative colitis (in remission) who on 03-JAN-2007, at 3:00 pm, was vaccinated intramuscularly into the right deltoid with the first dose of GARDASIL (Lot # 659978/0955F), during her holiday break from college. The physician reported that on 03-JAN-2007, at 3:15 pm, the patient experienced vaso-vagal faint. The patient awoke by herself. Unspecified medical attention was sought. Subsequently, the patient recovered from vaso-vagal faint. It was reported that the patient was embarrassed, then walked out to the care with her parents. Additional information is not expected.


Changed on 6/14/2014

274590 Before After
VAERS Form:
Age:22.0
Gender:Female
Location:Michigan
Vaccinated:2007-01-03
Onset:2007-01-03
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 0 RA / IM

Administered by: Other      Purchased by: Other
Symptoms: 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0702USA04082

Write-up:Information has been received from a physician concerning her daughter who was vaccinated with a dose of HPV during her Christmas holiday break from college. After the vaccination, the patient walked to the reception desk and fainted. The patient awoke by herself. Unspecified medical attention was sought. It was reported that the patient was embarrassed, then walked out to the car with her parents. Subsequently, the patient recovered. Additional information has been requested. This is in follow-up to report (s) previously submitted on 3/14/2007. Initial and follow-up information has been received from two physicians concerning their daughter, a 22 year old female with ulcerative colitis (in remission) who on 03-JAN-2007, at 3:00 pm, was vaccinated intramuscularly into the right deltoid with the first dose of GARDASIL (Lot # 659978/0955F), during her holiday break from college. The physician reported that on 03-JAN-2007, at 3:15 pm, the patient experienced vaso-vagal faint. The patient awoke by herself. Unspecified medical attention was sought. Subsequently, the patient recovered from vaso-vagal faint. It was reported that the patient was embarrassed, then walked out to the care with her parents. Additional information is not expected.


Changed on 5/14/2017

274590 Before After
VAERS Form:
Age:22.0
Gender:Female
Location:Michigan
Vaccinated:2007-01-03
Onset:2007-01-03
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 0 RA / IM

Administered by: Other      Purchased by: Other
Symptoms: 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0702USA04082

Write-up:Information has been received from a physician concerning her daughter who was vaccinated with a dose of HPV during her Christmas holiday break from college. After the vaccination, the patient walked to the reception desk and fainted. The patient awoke by herself. Unspecified medical attention was sought. It was reported that the patient was embarrassed, then walked out to the car with her parents. Subsequently, the patient recovered. Additional information has been requested. This is in follow-up to report (s) previously submitted on 3/14/2007. Initial and follow-up information has been received from two physicians concerning their daughter, a 22 year old female with ulcerative colitis (in remission) who on 03-JAN-2007, at 3:00 pm, was vaccinated intramuscularly into the right deltoid with the first dose of GARDASIL (Lot # 659978/0955F), during her holiday break from college. The physician reported that on 03-JAN-2007, at 3:15 pm, the patient experienced vaso-vagal faint. The patient awoke by herself. Unspecified medical attention was sought. Subsequently, the patient recovered from vaso-vagal faint. It was reported that the patient was embarrassed, then walked out to the care with her parents. Additional information is not expected.


Changed on 9/14/2017

274590 Before After
VAERS Form:(blank) 1
Age:22.0
Gender:Female
Location:Michigan
Vaccinated:2007-01-03
Onset:2007-01-03
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 0 1 RA / IM

Administered by: Other      Purchased by: Other
Symptoms: 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0702USA04082

Write-up:Information has been received from a physician concerning her daughter who was vaccinated with a dose of HPV during her Christmas holiday break from college. After the vaccination, the patient walked to the reception desk and fainted. The patient awoke by herself. Unspecified medical attention was sought. It was reported that the patient was embarrassed, then walked out to the car with her parents. Subsequently, the patient recovered. Additional information has been requested. This is in follow-up to report (s) previously submitted on 3/14/2007. Initial and follow-up information has been received from two physicians concerning their daughter, a 22 year old female with ulcerative colitis (in remission) who on 03-JAN-2007, at 3:00 pm, was vaccinated intramuscularly into the right deltoid with the first dose of GARDASIL (Lot # 659978/0955F), during her holiday break from college. The physician reported that on 03-JAN-2007, at 3:15 pm, the patient experienced vaso-vagal faint. The patient awoke by herself. Unspecified medical attention was sought. Subsequently, the patient recovered from vaso-vagal faint. It was reported that the patient was embarrassed, then walked out to the care with her parents. Additional information is not expected.


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