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This is VAERS ID 274707

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

274707
VAERS Form:
Age:13.0
Gender:Female
Location:Unknown
Vaccinated:2007-02-21
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: Loss of consciousness, Malaise

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

Write-up:Information has been received from a registered nurse concerning a 13 year old female who on 21 Feb 2007 was vaccinated with 0.5ml dose of Gardasil. Concomitant therapy included Adacel. Subsequently the patient /"felt sick/" and passed out. It was reporte"d that the patient was at home when she passed out but it was unknown how long after she received the vaccination. Unspecified medical attention was sought. The patient''''s outcome was unknown. Additional information has been requested.


Changed on 12/8/2009

274707 Before After
VAERS Form:
Age:13.0
Gender:Female
Location:Unknown
Vaccinated:2007-02-21
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: Loss of consciousness, Malaise

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:
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': (blank) WAES0702USA04343

Write-up:Information has been received from a registered nurse concerning a 13 year old female who on 21 Feb 2007 was vaccinated with 0.5ml dose of Gardasil. Concomitant therapy included Adacel. Subsequently the patient /"felt sick/" "felt sick" and passed out. It was reporte"d reported that the patient was at home when she passed out but it was unknown how long after she received the vaccination. Unspecified medical attention was sought. The patient''''s patient''s outcome was unknown. Additional information has been requested.


Changed on 9/14/2017

274707 Before After
VAERS Form:(blank) 1
Age:13.0
Gender:Female
Location:Unknown
Vaccinated:2007-02-21
Onset:0000-00-00
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Loss of consciousness, Malaise

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:
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0702USA04343

Write-up:Information has been received from a registered nurse concerning a 13 year old female who on 21 Feb 2007 was vaccinated with 0.5ml dose of Gardasil. Concomitant therapy included Adacel. Subsequently the patient "felt sick" and passed out. It was reported that the patient was at home when she passed out but it was unknown how long after she received the vaccination. Unspecified medical attention was sought. 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=274707&WAYBACKHISTORY=ON


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