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This is VAERS ID 276650

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 276650
VAERS Form:
Age:
Gender:Female
Location:New Jersey
Vaccinated:2006-12-12
Onset:2007-03-01
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN

Administered by: Unknown      Purchased by: Unknown
Symptoms: Loss of consciousness, 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: Unk
Current Illness:
Preexisting Conditions: Unk
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type':

Write-up: Information has been received from a physician concerning a female who on 12-DEC-2006 was vaccinated with 0.5 ml injection of Gardasil. In early March 2007, the patient passed out. The patient attributed the fainting to the Gardasil dose she received on 1"2-DEC-2006. Subsequently, the patient recovered. Additional information has been requested.


Changed on 12/8/2009

VAERS ID: 276650 Before After
VAERS Form:
Age:
Gender:Female
Location:New Jersey
Vaccinated:2006-12-12
Onset:2007-03-01
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN

Administered by: Unknown      Purchased by: Unknown
Symptoms: Loss of consciousness, 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: Unk
Current Illness:
Preexisting Conditions: Unk
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': (blank) WAES0703USA01569

Write-up: Information has been received from a physician concerning a female who on 12-DEC-2006 was vaccinated with 0.5 ml injection of Gardasil. In early March 2007, the patient passed out. The patient attributed the fainting to the Gardasil dose she received on 1"2-DEC-2006. 12-DEC-2006. Subsequently, the patient recovered. Additional information has been requested.


Changed on 9/14/2017

VAERS ID: 276650 Before After
VAERS Form:(blank) 1
Age:
Gender:Female
Location:New Jersey
Vaccinated:2006-12-12
Onset:2007-03-01
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UNK UN / UN

Administered by: Unknown      Purchased by: Unknown
Symptoms: Loss of consciousness, 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: Unk
Current Illness:
Preexisting Conditions: Unk
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0703USA01569

Write-up: Information has been received from a physician concerning a female who on 12-DEC-2006 was vaccinated with 0.5 ml injection of Gardasil. In early March 2007, the patient passed out. The patient attributed the fainting to the Gardasil dose she received on 12-DEC-2006. Subsequently, the patient recovered. Additional information has been requested.


Changed on 2/14/2018

VAERS ID: 276650 Before After
VAERS Form:1
Age:
Gender:Female
Location:New Jersey
Vaccinated:2006-12-12
Onset:2007-03-01
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Unknown      Purchased by: Unknown
Symptoms: Loss of consciousness, 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: Unk
Current Illness:
Preexisting Conditions: Unk
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0703USA01569

Write-up: Information has been received from a physician concerning a female who on 12-DEC-2006 was vaccinated with 0.5 ml injection of Gardasil. In early March 2007, the patient passed out. The patient attributed the fainting to the Gardasil dose she received on 12-DEC-2006. Subsequently, the patient recovered. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=276650&WAYBACKHISTORY=ON


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