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This is VAERS ID 276143

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

276143
VAERS Form:
Age:16.0
Gender:Female
Location:Unknown
Vaccinated:2007-02-26
Onset:2007-02-26
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type':

Write-up:Information has been received from a registered nurse concerning a 16 year old female with no previous drug reactions who on 26, Feb 2007, was vaccinated with HPV rL1 6 11 16 18 VLP vaccine (yeast) first dose. On 26, Feb 2007, the patient fainted after re"ceiving HPV rL1 6 11 16 18 VLP vaccine (yeast). Unspecified medical attention was sought. The patient recovered from fainting the same day the vaccine was received. Additional information has been requested.


Changed on 12/8/2009

276143 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Unknown
Vaccinated:2007-02-26
Onset:2007-02-26
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': (blank) WAES0703USA00680

Write-up:Information has been received from a registered nurse concerning a 16 year old female with no previous drug reactions who on 26, Feb 2007, was vaccinated with HPV rL1 6 11 16 18 VLP vaccine (yeast) first dose. On 26, Feb 2007, the patient fainted after re"ceiving receiving HPV rL1 6 11 16 18 VLP vaccine (yeast). Unspecified medical attention was sought. The patient recovered from fainting the same day the vaccine was received. Additional information has been requested.


Changed on 3/2/2010

276143 Before After
VAERS Form:
Age:16.0 18.0
Gender:Female
Location:Unknown New Jersey
Vaccinated:2007-02-26 2007-02-28
Onset:2007-02-26 2007-02-28
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - 0011U / 0 UN / IM

Administered by: Unknown Private      Purchased by: Unknown Private
Symptoms: 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0703USA00680

Write-up:Information has been received from a registered nurse concerning a 16 year old female with no previous drug reactions who on 26, Feb 2007, was vaccinated with HPV rL1 6 11 16 18 VLP vaccine (yeast) first dose. On 26, Feb 2007, the patient fainted after receiving HPV rL1 6 11 16 18 VLP vaccine (yeast). Unspecified medical attention was sought. The patient recovered from fainting the same day the vaccine was received. Additional information has been requested. This is in follow-up to report (s) previously submittedo n 4/6/2007. Initial follow up information has been received. Follow up information indicated that on 28-Feb-2007, the patient fainted (previously mentioned as on 26-Feb-2007) after receiving the first injection. Unspecified medical attention was sought. On 28-Feb-2007 patient recovered. Additional information is not expected.


Changed on 6/14/2014

276143 Before After
VAERS Form:
Age:18.0
Gender:Female
Location:New Jersey
Vaccinated:2007-02-28
Onset:2007-02-28
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 0 UN / IM

Administered by: Private      Purchased by: Private
Symptoms: 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0703USA00680

Write-up:Information has been received from a registered nurse concerning a 16 year old female with no previous drug reactions who on 26, Feb 2007, was vaccinated with HPV rL1 6 11 16 18 VLP vaccine (yeast) first dose. On 26, Feb 2007, the patient fainted after receiving HPV rL1 6 11 16 18 VLP vaccine (yeast). Unspecified medical attention was sought. The patient recovered from fainting the same day the vaccine was received. Additional information has been requested. This is in follow-up to report (s) previously submittedo n 4/6/2007. Initial follow up information has been received. Follow up information indicated that on 28-Feb-2007, the patient fainted (previously mentioned as on 26-Feb-2007) after receiving the first injection. Unspecified medical attention was sought. On 28-Feb-2007 patient recovered. Additional information is not expected.


Changed on 5/14/2017

276143 Before After
VAERS Form:
Age:18.0
Gender:Female
Location:New Jersey
Vaccinated:2007-02-28
Onset:2007-02-28
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 0 UN / IM

Administered by: Private      Purchased by: Private
Symptoms: 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0703USA00680

Write-up:Information has been received from a registered nurse concerning a 16 year old female with no previous drug reactions who on 26, Feb 2007, was vaccinated with HPV rL1 6 11 16 18 VLP vaccine (yeast) first dose. On 26, Feb 2007, the patient fainted after receiving HPV rL1 6 11 16 18 VLP vaccine (yeast). Unspecified medical attention was sought. The patient recovered from fainting the same day the vaccine was received. Additional information has been requested. This is in follow-up to report (s) previously submittedo n 4/6/2007. Initial follow up information has been received. Follow up information indicated that on 28-Feb-2007, the patient fainted (previously mentioned as on 26-Feb-2007) after receiving the first injection. Unspecified medical attention was sought. On 28-Feb-2007 patient recovered. Additional information is not expected.


Changed on 9/14/2017

276143 Before After
VAERS Form:(blank) 1
Age:18.0
Gender:Female
Location:New Jersey
Vaccinated:2007-02-28
Onset:2007-02-28
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 0 1 UN / IM

Administered by: Private      Purchased by: Private
Symptoms: 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0703USA00680

Write-up:Information has been received from a registered nurse concerning a 16 year old female with no previous drug reactions who on 26, Feb 2007, was vaccinated with HPV rL1 6 11 16 18 VLP vaccine (yeast) first dose. On 26, Feb 2007, the patient fainted after receiving HPV rL1 6 11 16 18 VLP vaccine (yeast). Unspecified medical attention was sought. The patient recovered from fainting the same day the vaccine was received. Additional information has been requested. This is in follow-up to report (s) previously submittedo n 4/6/2007. Initial follow up information has been received. Follow up information indicated that on 28-Feb-2007, the patient fainted (previously mentioned as on 26-Feb-2007) after receiving the first injection. Unspecified medical attention was sought. On 28-Feb-2007 patient recovered. Additional information is not expected.


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