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This is VAERS ID 275314

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

275314
VAERS Form:
Age:13.0
Gender:Female
Location:South Carolina
Vaccinated:2007-03-30
Onset:2007-03-30
Submitted:2007-03-30
Entered:2007-03-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1208F / 0 LA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Blood glucose normal, Blood pressure normal, Dizziness, Heart rate normal, Injection site pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None, NKDA, H/O Reflux
Allergies:
Diagnostic Lab Data: Glucose 96, B/P 104/86, Sat 99%, pulse 75
CDC 'Split Type':

Write-up:Dizziness, Syncope recovered in few minutes. Patient also complained of severe pain at Vaccine site. Tylenol PO given.


Changed on 12/8/2009

275314 Before After
VAERS Form:
Age:13.0
Gender:Female
Location:South Carolina
Vaccinated:2007-03-30
Onset:2007-03-30
Submitted:2007-03-30
Entered:2007-03-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1208F / 0 LA / IM

Administered by: Other      Purchased by: Unknown Public
Symptoms: Blood glucose normal, Blood pressure normal, Dizziness, Heart rate normal, Injection site pain, Oxygen saturation normal, 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)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None, NKDA, H/O Reflux
Allergies:
Diagnostic Lab Data: Glucose 96, B/P 104/86, Sat 99%, pulse 75
CDC 'Split Type':

Write-up:Dizziness, Syncope recovered in few minutes. Patient also complained of severe pain at Vaccine site. Tylenol PO given.


Changed on 9/14/2017

275314 Before After
VAERS Form:(blank) 1
Age:13.0
Gender:Female
Location:South Carolina
Vaccinated:2007-03-30
Onset:2007-03-30
Submitted:2007-03-30
Entered:2007-03-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1208F / 0 1 LA / IM

Administered by: Other      Purchased by: Public
Symptoms: Blood glucose normal, Blood pressure normal, Dizziness, Heart rate normal, Injection site pain, Oxygen saturation normal, 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)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None, NKDA, H/O Reflux
Allergies:
Diagnostic Lab Data: Glucose 96, B/P 104/86, Sat 99%, pulse 75
CDC 'Split Type':

Write-up:Dizziness, Syncope recovered in few minutes. Patient also complained of severe pain at Vaccine site. Tylenol PO given.


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