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This is VAERS ID 275829

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

275829
VAERS Form:
Age:17.0
Gender:Female
Location:Florida
Vaccinated:2007-04-04
Onset:2007-04-04
Submitted:2007-04-04
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0188U / 0 RA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR U1932AB / 0 RA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Blood glucose normal, Dizziness, Fatigue, Gait disturbance, Hypotension

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:
Current Illness:
Preexisting Conditions: None/NKDA
Allergies:
Diagnostic Lab Data: Blood Glucose (normal)
CDC 'Split Type':

Write-up:Dizziness, pt stated that she was feeling tired, faint, could not walk, almost passed, pale face, low blood pressure. But she was conscious the whole time. The whole episode happened about 10 minutes after receiving the vaccines. She was monitored in the"office until she was feeling better. She walked out of the office at 1230 PM. Received the shots at 1140.


Changed on 12/8/2009

275829 Before After
VAERS Form:
Age:17.0
Gender:Female
Location:Florida
Vaccinated:2007-04-04
Onset:2007-04-04
Submitted:2007-04-04
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0188U / 0 RA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR U1932AB / 0 RA / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Blood glucose normal, Dizziness, Fatigue, Gait disturbance, Hypotension, Pallor, 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:
Current Illness:
Preexisting Conditions: None/NKDA
Allergies:
Diagnostic Lab Data: Blood Glucose (normal)
CDC 'Split Type':

Write-up:Dizziness, pt stated that she was feeling tired, faint, could not walk, almost passed, pale face, low blood pressure. But she was conscious the whole time. The whole episode happened about 10 minutes after receiving the vaccines. She was monitored in the"office the office until she was feeling better. She walked out of the office at 1230 PM. Received the shots at 1140.


Changed on 4/7/2010

275829 Before After
VAERS Form:
Age:17.0
Gender:Female
Location:Florida
Vaccinated:2007-04-04
Onset:2007-04-04
Submitted:2007-04-04
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0188U / 0 RA / IM
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR U1932AB / 0 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Blood glucose normal, Dizziness, Fatigue, Gait disturbance, Hypotension, Pallor, 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:
Current Illness:
Preexisting Conditions: None/NKDA
Allergies:
Diagnostic Lab Data: Blood Glucose (normal)
CDC 'Split Type':

Write-up:Dizziness, pt stated that she was feeling tired, faint, could not walk, almost passed, pale face, low blood pressure. But she was conscious the whole time. The whole episode happened about 10 minutes after receiving the vaccines. She was monitored in the office until she was feeling better. She walked out of the office at 1230 PM. Received the shots at 1140.


Changed on 5/14/2017

275829 Before After
VAERS Form:
Age:17.0
Gender:Female
Location:Florida
Vaccinated:2007-04-04
Onset:2007-04-04
Submitted:2007-04-04
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0188U / 0 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR SANOFI PASTEUR U1932AB / 0 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Blood glucose normal, Dizziness, Fatigue, Gait disturbance, Hypotension, Pallor, 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:
Current Illness:
Preexisting Conditions: None/NKDA
Allergies:
Diagnostic Lab Data: Blood Glucose (normal)
CDC 'Split Type':

Write-up:Dizziness, pt stated that she was feeling tired, faint, could not walk, almost passed, pale face, low blood pressure. But she was conscious the whole time. The whole episode happened about 10 minutes after receiving the vaccines. She was monitored in the office until she was feeling better. She walked out of the office at 1230 PM. Received the shots at 1140.


Changed on 9/14/2017

275829 Before After
VAERS Form:(blank) 1
Age:17.0
Gender:Female
Location:Florida
Vaccinated:2007-04-04
Onset:2007-04-04
Submitted:2007-04-04
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0188U / 0 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1932AB / 0 1 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Blood glucose normal, Dizziness, Fatigue, Gait disturbance, Hypotension, Pallor, 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:
Current Illness:
Preexisting Conditions: None/NKDA
Allergies:
Diagnostic Lab Data: Blood Glucose (normal)
CDC 'Split Type':

Write-up:Dizziness, pt stated that she was feeling tired, faint, could not walk, almost passed, pale face, low blood pressure. But she was conscious the whole time. The whole episode happened about 10 minutes after receiving the vaccines. She was monitored in the office until she was feeling better. She walked out of the office at 1230 PM. Received the shots at 1140.


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