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This is VAERS ID 276240

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

276240
VAERS Form:
Age:17.0
Gender:Female
Location:New York
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 / UN

Administered by: Other      Purchased by: Unknown
Symptoms: Diarrhoea, Dizziness, Eye haemorrhage, Nausea

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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 an office receptionist concerning her 17 year old step daughter who on an unspecified date was vaccinated with first dose Gardasil. The patient experienced extreme nausea, diarrhea and dizziness after the injection. /"Pa"tient was vomiting so hard, that the blood vessels in her eyes broke./" The patient''''s outcome was unknown. Additional information has been requested.


Changed on 12/8/2009

276240 Before After
VAERS Form:
Age:17.0
Gender:Female
Location:New York
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 / UN

Administered by: Other      Purchased by: Unknown Other
Symptoms: Diarrhoea, Dizziness, Eye haemorrhage, Nausea

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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) WAES0703USA01943

Write-up:Information has been received from an office receptionist concerning her 17 year old step daughter who on an unspecified date was vaccinated with first dose Gardasil. The patient experienced extreme nausea, diarrhea and dizziness after the injection. /"Pa"tient "Patient was vomiting so hard, that the blood vessels in her eyes broke./" broke." The patient''''s patient''s outcome was unknown. Additional information has been requested.


Changed on 3/2/2010

276240 Before After
VAERS Form:
Age:17.0
Gender:Female
Location:New York
Vaccinated:0000-00-00 2007-02-28
Onset:0000-00-00 2007-03-01
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - 0960F / 0 UN LA / UN

Administered by: Other Private      Purchased by: Other Public
Symptoms: Diarrhoea, Dizziness, Eye haemorrhage, Nausea

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No 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': WAES0703USA01943

Write-up:Information This is in follow-up to report(s) previously submitted on 4/6/2007. Initial and follow up information has been received from an office receptionist and a nurse practitioner(N.P.) concerning her 17 year old step daughter who on an unspecified date 28-FEB-2007, at 2:30 PM was vaccinated in the left arm with a first dose Gardasil. of GARDASIL lot #654535/0960F. The patient experienced extreme nausea, diarrhea and dizziness after the injection. "Patient was vomiting so hard, that the blood vessels in her eyes broke." The patient''s outcome was unknown. In follow-up it was indicated that patient started vomiting on 01-MAR-2007 at 03:00 AM and vomited 8 times. She broke blood vessels in both eyes. Her diarrhea continued for 24 hours and she was very tired, slept a lot and missed 2 days of school. On 03-MAR-2007 patient recovered. Additional information has been requested. is not expected.


Changed on 4/7/2010

276240 Before After
VAERS Form:
Age:17.0
Gender:Female
Location:New York
Vaccinated:2007-02-28
Onset:2007-03-01
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0960F / 0 LA / UN

Administered by: Private      Purchased by: Public
Symptoms: Diarrhoea, Dizziness, Eye haemorrhage, Fatigue, Nausea, Vomiting

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': WAES0703USA01943

Write-up:This is in follow-up to report(s) previously submitted on 4/6/2007. Initial and follow up information has been received from an office receptionist and a nurse practitioner(N.P.) concerning her 17 year old step daughter who on 28-FEB-2007, at 2:30 PM was vaccinated in the left arm with a first dose of GARDASIL lot #654535/0960F. The patient experienced extreme nausea, diarrhea and dizziness after the injection. "Patient was vomiting so hard, that the blood vessels in her eyes broke." The patient''s outcome was unknown. In follow-up it was indicated that patient started vomiting on 01-MAR-2007 at 03:00 AM and vomited 8 times. She broke blood vessels in both eyes. Her diarrhea continued for 24 hours and she was very tired, slept a lot and missed 2 days of school. On 03-MAR-2007 patient recovered. Additional information is not expected.


Changed on 6/14/2014

276240 Before After
VAERS Form:
Age:17.0
Gender:Female
Location:New York
Vaccinated:2007-02-28
Onset:2007-03-01
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0960F / 0 LA / UN

Administered by: Private      Purchased by: Public
Symptoms: Diarrhoea, Dizziness, Eye haemorrhage, Fatigue, Nausea, Vomiting

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': WAES0703USA01943

Write-up:This is in follow-up to report(s) previously submitted on 4/6/2007. Initial and follow up information has been received from an office receptionist and a nurse practitioner(N.P.) concerning her 17 year old step daughter who on 28-FEB-2007, at 2:30 PM was vaccinated in the left arm with a first dose of GARDASIL lot #654535/0960F. The patient experienced extreme nausea, diarrhea and dizziness after the injection. "Patient was vomiting so hard, that the blood vessels in her eyes broke." The patient''s outcome was unknown. In follow-up it was indicated that patient started vomiting on 01-MAR-2007 at 03:00 AM and vomited 8 times. She broke blood vessels in both eyes. Her diarrhea continued for 24 hours and she was very tired, slept a lot and missed 2 days of school. On 03-MAR-2007 patient recovered. Additional information is not expected.


Changed on 5/14/2017

276240 Before After
VAERS Form:
Age:17.0
Gender:Female
Location:New York
Vaccinated:2007-02-28
Onset:2007-03-01
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0960F / 0 LA / UN

Administered by: Private      Purchased by: Public
Symptoms: Diarrhoea, Dizziness, Eye haemorrhage, Fatigue, Nausea, Vomiting

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': WAES0703USA01943

Write-up:This is in follow-up to report(s) previously submitted on 4/6/2007. Initial and follow up information has been received from an office receptionist and a nurse practitioner(N.P.) concerning her 17 year old step daughter who on 28-FEB-2007, at 2:30 PM was vaccinated in the left arm with a first dose of GARDASIL lot #654535/0960F. The patient experienced extreme nausea, diarrhea and dizziness after the injection. "Patient was vomiting so hard, that the blood vessels in her eyes broke." The patient''s outcome was unknown. In follow-up it was indicated that patient started vomiting on 01-MAR-2007 at 03:00 AM and vomited 8 times. She broke blood vessels in both eyes. Her diarrhea continued for 24 hours and she was very tired, slept a lot and missed 2 days of school. On 03-MAR-2007 patient recovered. Additional information is not expected.


Changed on 9/14/2017

276240 Before After
VAERS Form:(blank) 1
Age:17.0
Gender:Female
Location:New York
Vaccinated:2007-02-28
Onset:2007-03-01
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0960F / 0 1 LA / UN

Administered by: Private      Purchased by: Public
Symptoms: Diarrhoea, Dizziness, Eye haemorrhage, Fatigue, Nausea, Vomiting

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': WAES0703USA01943

Write-up:This is in follow-up to report(s) previously submitted on 4/6/2007. Initial and follow up information has been received from an office receptionist and a nurse practitioner(N.P.) concerning her 17 year old step daughter who on 28-FEB-2007, at 2:30 PM was vaccinated in the left arm with a first dose of GARDASIL lot #654535/0960F. The patient experienced extreme nausea, diarrhea and dizziness after the injection. "Patient was vomiting so hard, that the blood vessels in her eyes broke." The patient''s outcome was unknown. In follow-up it was indicated that patient started vomiting on 01-MAR-2007 at 03:00 AM and vomited 8 times. She broke blood vessels in both eyes. Her diarrhea continued for 24 hours and she was very tired, slept a lot and missed 2 days of school. On 03-MAR-2007 patient recovered. Additional information is not expected.


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