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This is VAERS ID 274712

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

274712
VAERS Form:
Age:19.0
Gender:Female
Location:New York
Vaccinated:2005-02-15
Onset:2007-02-15
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0954F / - - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Blood pressure normal, Diarrhoea, Dizziness, Fall, Loss of consciousness

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up:Information has been received from a registered nurse concerning a 21 year old female patient with autoimmune hepatitis, who on 15 Feb 2005 was vaccinated with a dose, 0.5ml, IM, of Gardasil. Concomitant suspect therapy included Adacel, and other concomit"ant medication included birth control pills, prednisone, vitamins (unspecified) and calcium (unspecified). The nurse reported that on 15 Feb 2007, /"20 hours later,/" the patient /"felt lightheaded and passed out. She came to and when she got up she passe


Changed on 12/8/2009

274712 Before After
VAERS Form:
Age:19.0
Gender:Female
Location:New York
Vaccinated:2005-02-15
Onset:2007-02-15
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0954F / - - / IM

Administered by: Private      Purchased by: Unknown Other
Symptoms: Blood pressure normal, Diarrhoea, Dizziness, Fall, Loss of consciousness

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': (blank) WAES0702USA04396

Write-up:Information has been received from a registered nurse concerning a 21 year old female patient with autoimmune hepatitis, who on 15 Feb 2005 was vaccinated with a dose, 0.5ml, IM, of Gardasil. Concomitant suspect therapy included Adacel, and other concomit"ant concomitant medication included birth control pills, prednisone, vitamins (unspecified) and calcium (unspecified). The nurse reported that on 15 Feb 2007, /"20 "20 hours later,/" later," the patient /"felt "felt lightheaded and passed out. She came to and when she got up she passe passed out and fell to the floor." The nurse further stated that "both episodes were very brief." On approximately 16 Feb 2007 ("later") the patient "had one episode of diarrhea." On the morning of 16 Feb 2007, the nurse stated that the patient was seen by the doctor and "blood pressure was normal and injection site looked fine. No treatment required." At the time of this report, the patient had recovered. Additional information has been requested.


Changed on 3/2/2010

274712 Before After
VAERS Form:
Age:19.0
Gender:Female
Location:New York
Vaccinated:2005-02-15
Onset:2007-02-15 2007-02-16
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0954F / - 0 - / IM

Administered by: Private      Purchased by: Other Private
Symptoms: Blood pressure normal, Diarrhoea, Dizziness, Fall, Loss of consciousness

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: calcium (unspecified); hormonal contraceptive; prednisone 5mg; vitamins (unspecified)
Current Illness: Autoimmune hepatitis
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: NONE None
CDC 'Split Type': WAES0702USA04396

Write-up:Information has been received from a registered nurse concerning a 21 year old female patient with autoimmune hepatitis, who on 15 Feb 2005 was vaccinated with a dose, 0.5ml, IM, of Gardasil. Concomitant suspect therapy included Adacel, and other concomitant medication included birth control pills, prednisone, vitamins (unspecified) and calcium (unspecified). The nurse reported that on 15 Feb 2007, "20 hours later," the patient "felt lightheaded and passed out. She came to and when she got up she passed out and fell to the floor." The nurse further stated that "both episodes were very brief." On approximately 16 Feb 2007 ("later") the patient "had one episode of diarrhea." On the morning of 16 Feb 2007, the nurse stated that the patient was seen by the doctor and "blood pressure was normal and injection site looked fine. No treatment required." At the time of this report, the patient had recovered. Additional information has been requested. Information received 04/03/2009. The nurse confirmed that the patient actually experienced "two concurrent bried syncopal episodes." Additional information has been requested.


Changed on 4/7/2010

274712 Before After
VAERS Form:
Age:19.0
Gender:Female
Location:New York
Vaccinated:2005-02-15
Onset:2007-02-16
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0954F / 0 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Blood pressure normal, Diarrhoea, Dizziness, Fall, Loss of consciousness

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: calcium (unspecified); hormonal contraceptive; prednisone 5mg; vitamins (unspecified)
Current Illness: Autoimmune hepatitis
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0702USA04396

Write-up:Information has been received from a registered nurse concerning a 21 year old female patient with autoimmune hepatitis, who on 15 Feb 2005 was vaccinated with a dose, 0.5ml, IM, of Gardasil. Concomitant suspect therapy included Adacel, and other concomitant medication included birth control pills, prednisone, vitamins (unspecified) and calcium (unspecified). The nurse reported that on 15 Feb 2007, "20 hours later," the patient "felt lightheaded and passed out. She came to and when she got up she passed out and fell to the floor." The nurse further stated that "both episodes were very brief." On approximately 16 Feb 2007 ("later") the patient "had one episode of diarrhea." On the morning of 16 Feb 2007, the nurse stated that the patient was seen by the doctor and "blood pressure was normal and injection site looked fine. No treatment required." At the time of this report, the patient had recovered. Additional information has been requested. Information received 04/03/2009. The nurse confirmed that the patient actually experienced "two concurrent bried syncopal episodes." Additional information has been requested.


Changed on 6/14/2014

274712 Before After
VAERS Form:
Age:19.0
Gender:Female
Location:New York
Vaccinated:2005-02-15
Onset:2007-02-16
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0954F / 0 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Blood pressure normal, Diarrhoea, Dizziness, Fall, Loss of consciousness

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: calcium (unspecified); hormonal contraceptive; prednisone 5mg; vitamins (unspecified)
Current Illness: Autoimmune hepatitis
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0702USA04396

Write-up:Information has been received from a registered nurse concerning a 21 year old female patient with autoimmune hepatitis, who on 15 Feb 2005 was vaccinated with a dose, 0.5ml, IM, of Gardasil. Concomitant suspect therapy included Adacel, and other concomitant medication included birth control pills, prednisone, vitamins (unspecified) and calcium (unspecified). The nurse reported that on 15 Feb 2007, "20 hours later," the patient "felt lightheaded and passed out. She came to and when she got up she passed out and fell to the floor." The nurse further stated that "both episodes were very brief." On approximately 16 Feb 2007 ("later") the patient "had one episode of diarrhea." On the morning of 16 Feb 2007, the nurse stated that the patient was seen by the doctor and "blood pressure was normal and injection site looked fine. No treatment required." At the time of this report, the patient had recovered. Additional information has been requested. Information received 04/03/2009. The nurse confirmed that the patient actually experienced "two concurrent bried syncopal episodes." Additional information has been requested.


Changed on 5/14/2017

274712 Before After
VAERS Form:
Age:19.0
Gender:Female
Location:New York
Vaccinated:2005-02-15
Onset:2007-02-16
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0954F / 0 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Blood pressure normal, Diarrhoea, Dizziness, Fall, Loss of consciousness

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: calcium (unspecified); hormonal contraceptive; prednisone 5mg; vitamins (unspecified)
Current Illness: Autoimmune hepatitis
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0702USA04396

Write-up:Information has been received from a registered nurse concerning a 21 year old female patient with autoimmune hepatitis, who on 15 Feb 2005 was vaccinated with a dose, 0.5ml, IM, of Gardasil. Concomitant suspect therapy included Adacel, and other concomitant medication included birth control pills, prednisone, vitamins (unspecified) and calcium (unspecified). The nurse reported that on 15 Feb 2007, "20 hours later," the patient "felt lightheaded and passed out. She came to and when she got up she passed out and fell to the floor." The nurse further stated that "both episodes were very brief." On approximately 16 Feb 2007 ("later") the patient "had one episode of diarrhea." On the morning of 16 Feb 2007, the nurse stated that the patient was seen by the doctor and "blood pressure was normal and injection site looked fine. No treatment required." At the time of this report, the patient had recovered. Additional information has been requested. Information received 04/03/2009. The nurse confirmed that the patient actually experienced "two concurrent bried syncopal episodes." Additional information has been requested.


Changed on 9/14/2017

274712 Before After
VAERS Form:(blank) 1
Age:19.0
Gender:Female
Location:New York
Vaccinated:2005-02-15
Onset:2007-02-16
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0954F / 0 1 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Blood pressure normal, Diarrhoea, Dizziness, Fall, Loss of consciousness

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: calcium (unspecified); hormonal contraceptive; prednisone 5mg; vitamins (unspecified)
Current Illness: Autoimmune hepatitis
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0702USA04396

Write-up:Information has been received from a registered nurse concerning a 21 year old female patient with autoimmune hepatitis, who on 15 Feb 2005 was vaccinated with a dose, 0.5ml, IM, of Gardasil. Concomitant suspect therapy included Adacel, and other concomitant medication included birth control pills, prednisone, vitamins (unspecified) and calcium (unspecified). The nurse reported that on 15 Feb 2007, "20 hours later," the patient "felt lightheaded and passed out. She came to and when she got up she passed out and fell to the floor." The nurse further stated that "both episodes were very brief." On approximately 16 Feb 2007 ("later") the patient "had one episode of diarrhea." On the morning of 16 Feb 2007, the nurse stated that the patient was seen by the doctor and "blood pressure was normal and injection site looked fine. No treatment required." At the time of this report, the patient had recovered. Additional information has been requested. Information received 04/03/2009. The nurse confirmed that the patient actually experienced "two concurrent bried syncopal episodes." Additional information has been requested.


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