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This is VAERS ID 276066

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

276066
VAERS Form:
Age:16.0
Gender:Female
Location:Rhode Island
Vaccinated:2007-03-20
Onset:2007-03-20
Submitted:2007-04-11
Entered:2007-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0263U / 0 RA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Hyperhidrosis, 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: Doxycycline 1xd on/off for ache
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up:Administered vaccine with on incidents. Suddenly with in 2-3 mins. became faint, sweaty, pale layed pt down on exam table. Responded immediately BP 98/56 AP 68. Observation, cool drink rest no further incidence-discharged with mom (did not drug herself).


Changed on 12/8/2009

276066 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Rhode Island
Vaccinated:2007-03-20
Onset:2007-03-20
Submitted:2007-04-11
Entered:2007-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0263U / 0 RA / IM

Administered by: Private      Purchased by: Unknown Public
Symptoms: Hyperhidrosis, 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: Doxycycline 1xd on/off for ache
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up:Administered vaccine with on incidents. Suddenly with in 2-3 mins. became faint, sweaty, pale layed pt down on exam table. Responded immediately BP 98/56 AP 68. Observation, cool drink rest no further incidence-discharged with mom (did not drug herself).


Changed on 9/14/2017

276066 Before After
VAERS Form:(blank) 1
Age:16.0
Gender:Female
Location:Rhode Island
Vaccinated:2007-03-20
Onset:2007-03-20
Submitted:2007-04-11
Entered:2007-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0263U / 0 1 RA / IM

Administered by: Private      Purchased by: Public
Symptoms: Hyperhidrosis, 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: Doxycycline 1xd on/off for ache
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up:Administered vaccine with on incidents. Suddenly with in 2-3 mins. became faint, sweaty, pale layed pt down on exam table. Responded immediately BP 98/56 AP 68. Observation, cool drink rest no further incidence-discharged with mom (did not drug herself).


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=276066&WAYBACKHISTORY=ON


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