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This is VAERS ID 274788

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

274788
VAERS Form:
Age:18.0
Gender:Female
Location:California
Vaccinated:2007-03-15
Onset:2007-03-15
Submitted:2007-03-15
Entered:2007-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0187U / 0 RA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR 02002AC / 0 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Blood pressure decreased, Fall, 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:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:After getting 1 Menactra vaccine to her Left deltoid and 2 HPV vaccines to her Right deltoid. Patient fainted and fell down to the floor, nonconscious. Approx 2 min she became alert and her Blood pressure 90/60. 911 was called and she was brought to hospi"tal in stable condition.


Changed on 12/8/2009

274788 Before After
VAERS Form:
Age:18.0
Gender:Female
Location:California
Vaccinated:2007-03-15
Onset:2007-03-15
Submitted:2007-03-15
Entered:2007-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0187U / 0 RA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR 02002AC / 0 LA / IM

Administered by: Private      Purchased by: Unknown Public
Symptoms: Blood pressure decreased, Fall, 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:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:After getting 1 Menactra vaccine to her Left deltoid and 2 HPV vaccines to her Right deltoid. Patient fainted and fell down to the floor, nonconscious. Approx 2 min she became alert and her Blood pressure 90/60. 911 was called and she was brought to hospi"tal hospital in stable condition.


Changed on 4/7/2010

274788 Before After
VAERS Form:
Age:18.0
Gender:Female
Location:California
Vaccinated:2007-03-15
Onset:2007-03-15
Submitted:2007-03-15
Entered:2007-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0187U / 0 RA / IM
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR 02002AC / 0 LA / IM

Administered by: Private      Purchased by: Public
Symptoms: Blood pressure decreased, Fall, 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:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:After getting 1 Menactra vaccine to her Left deltoid and 2 HPV vaccines to her Right deltoid. Patient fainted and fell down to the floor, nonconscious. Approx 2 min she became alert and her Blood pressure 90/60. 911 was called and she was brought to hospital in stable condition.


Changed on 5/14/2017

274788 Before After
VAERS Form:
Age:18.0
Gender:Female
Location:California
Vaccinated:2007-03-15
Onset:2007-03-15
Submitted:2007-03-15
Entered:2007-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0187U / 0 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR SANOFI PASTEUR 02002AC / 0 LA / IM

Administered by: Private      Purchased by: Public
Symptoms: Blood pressure decreased, Fall, 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:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:After getting 1 Menactra vaccine to her Left deltoid and 2 HPV vaccines to her Right deltoid. Patient fainted and fell down to the floor, nonconscious. Approx 2 min she became alert and her Blood pressure 90/60. 911 was called and she was brought to hospital in stable condition.


Changed on 9/14/2017

274788 Before After
VAERS Form:(blank) 1
Age:18.0
Gender:Female
Location:California
Vaccinated:2007-03-15
Onset:2007-03-15
Submitted:2007-03-15
Entered:2007-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0187U / 0 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR 02002AC / 0 1 LA / IM

Administered by: Private      Purchased by: Public
Symptoms: Blood pressure decreased, Fall, 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:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:After getting 1 Menactra vaccine to her Left deltoid and 2 HPV vaccines to her Right deltoid. Patient fainted and fell down to the floor, nonconscious. Approx 2 min she became alert and her Blood pressure 90/60. 911 was called and she was brought to hospital in stable condition.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=274788&WAYBACKHISTORY=ON


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