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This is VAERS ID 276230

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

276230
VAERS Form:
Age:17.0
Gender:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / -

Administered by: Other      Purchased by: Unknown
Symptoms: Dizziness, Injection site irritation, Injection site pain, Presyncope, Immediate post-injection reaction

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:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type':

Write-up:Information has been received from a physician concerning a 17 year old female who was vaccinated with HPV rL1 6 11 16 18 VLP vaccine (yeast) first dose. Concomitant therapy included diphtheria toxoid (+) pertussis acellular vaccine (unspecified) (+) teta"nus toxoid administered right before HPV rL1 6 11 16 18 VLP vaccine. The patient said that while she was being administered the HPV rL1 6 11 16 18 VLP vaccine (also reported as immediately after receiving HPV rL1 6 11 16 18 VLP vaccine), she had stinging


Changed on 12/8/2009

276230 Before After
VAERS Form:
Age:17.0
Gender:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Dizziness, Injection site irritation, Injection site pain, Presyncope, Immediate post-injection reaction

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:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': (blank) WAES0703USA01306

Write-up:Information has been received from a physician concerning a 17 year old female who was vaccinated with HPV rL1 6 11 16 18 VLP vaccine (yeast) Gardasil first dose. Concomitant therapy included diphtheria toxoid (+) pertussis acellular vaccine (unspecified) (+) teta"nus tetanus toxoid administered right before HPV rL1 6 11 16 18 VLP vaccine. Gardasil. The patient said that while she was being administered the HPV rL1 6 11 16 18 VLP vaccine Gartdasil (also reported as immediately after receiving HPV rL1 6 11 16 18 VLP vaccine), Gardasil, she had stinging and burning sensation (at injection site) and felt as if she was going to faint or pass out. The feeling lasted for approximately fifteen minutes. Thereafter, she felt "okay" Subsequently, the patient recovered. Additional information has been requested.


Changed on 9/14/2017

276230 Before After
VAERS Form:(blank) 1
Age:17.0
Gender:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 1 UN / -

Administered by: Other      Purchased by: Other
Symptoms: Dizziness, Injection site irritation, Injection site pain, Presyncope, Immediate post-injection reaction

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:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0703USA01306

Write-up:Information has been received from a physician concerning a 17 year old female who was vaccinated with Gardasil first dose. Concomitant therapy included diphtheria toxoid (+) pertussis acellular vaccine (unspecified) (+) tetanus toxoid administered right before Gardasil. The patient said that while she was being administered the Gartdasil (also reported as immediately after receiving Gardasil, she had stinging and burning sensation (at injection site) and felt as if she was going to faint or pass out. The feeling lasted for approximately fifteen minutes. Thereafter, she felt "okay" Subsequently, the patient recovered. Additional information has been requested.


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