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This is VAERS ID 276670

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 276670
Age:15.0
Gender:Female
Location:Texas
Vaccinated:2007-03-09
Onset:2007-03-09
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Fall, Syncope

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type':

Write-up:Information has been received from a nurse concerning a 15 year old female who on 09-MAR-2007 was vaccinated with Gardasil (lot# not reported). 0.5 ml once IM. On 09-MAR-2007, after receiving the injection, the patient fainted and fell from the chair wher"e she was sitting. Medical attention was sought. However, she regained consciousness after five minutes. She went home after the recovery. No further information was available at the time of reporting. Additional information has been requested.


Changed on 12/8/2009

VAERS ID: 276670 Before After
Age:15.0
Gender:Female
Location:Texas
Vaccinated:2007-03-09
Onset:2007-03-09
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Fall, Syncope

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type': (blank) WAES0703USA02372

Write-up:Information has been received from a nurse concerning a 15 year old female who on 09-MAR-2007 was vaccinated with Gardasil (lot# not reported). 0.5 ml once IM. On 09-MAR-2007, after receiving the injection, the patient fainted and fell from the chair wher"e where she was sitting. Medical attention was sought. However, she regained consciousness after five minutes. She went home after the recovery. No further information was available at the time of reporting. Additional information has been requested.


Changed on 3/2/2010

VAERS ID: 276670 Before After
Age:15.0 16.0
Gender:Female
Location:Texas
Vaccinated:2007-03-09 2007-03-02
Onset:2007-03-09 2007-03-02
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - 0188U / - 0 UN LA / IM

Administered by: Other Private      Purchased by: Other Private
Symptoms: Fall, Syncope

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0703USA02372

Write-up:Information has been received from a nurse concerning a 15 16 year old female (ptreviously reported as 15 year old) with no illness at the time of vaccination and no pre-existing illness or allergies who on 09-MAR-2007 02-MAR-2007 (previously reported as 09-MAR-2007) was vaccinated with first dose of Gardasil (lot# not reported). 657006/0188U). 0.5 ml once IM. IM in the left deltoid at 5:15 PM. On 09-MAR-2007, 02-MAR-2007, after receiving the injection, the patient fainted and fell from the chair where she was sitting. Medical attention was sought. However, she regained consciousness after five minutes. She went home after the recovery. No further information was available at the time of reporting. Additional information has been requested. Additional infromation was received from a licensed vocational nurse. On 02-MAR-2007, at 5:15 PM after receiving the vaccination the patient stated that she felt lightheaded and fell forward and laid her head on the nurses shoulder. The patient then briefly had a "seizure like" motion of her head. The nurse laid her back on the table. The patient quickly resumed normal fucntion and stated she felt fine. The physician stated vasovagal episode. No additional information is expected.


Changed on 6/14/2014

VAERS ID: 276670 Before After
Age:16.0
Gender:Female
Location:Texas
Vaccinated:2007-03-02
Onset:2007-03-02
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0188U / 0 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Fall, Syncope

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0703USA02372

Write-up:Information has been received from a nurse concerning a 16 year old female (ptreviously reported as 15 year old) with no illness at the time of vaccination and no pre-existing illness or allergies who on 02-MAR-2007 (previously reported as 09-MAR-2007) was vaccinated with first dose of Gardasil (lot# 657006/0188U). 0.5 ml once IM in the left deltoid at 5:15 PM. On 02-MAR-2007, after receiving the injection, the patient fainted and fell from the chair where she was sitting. Medical attention was sought. However, she regained consciousness after five minutes. She went home after the recovery. No further information was available at the time of reporting. Additional information has been requested. Additional infromation was received from a licensed vocational nurse. On 02-MAR-2007, at 5:15 PM after receiving the vaccination the patient stated that she felt lightheaded and fell forward and laid her head on the nurses shoulder. The patient then briefly had a "seizure like" motion of her head. The nurse laid her back on the table. The patient quickly resumed normal fucntion and stated she felt fine. The physician stated vasovagal episode. No additional information is expected.


Changed on 5/14/2017

VAERS ID: 276670 Before After
Age:16.0
Gender:Female
Location:Texas
Vaccinated:2007-03-02
Onset:2007-03-02
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0188U / 0 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Fall, Syncope

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0703USA02372

Write-up:Information has been received from a nurse concerning a 16 year old female (ptreviously reported as 15 year old) with no illness at the time of vaccination and no pre-existing illness or allergies who on 02-MAR-2007 (previously reported as 09-MAR-2007) was vaccinated with first dose of Gardasil (lot# 657006/0188U). 0.5 ml once IM in the left deltoid at 5:15 PM. On 02-MAR-2007, after receiving the injection, the patient fainted and fell from the chair where she was sitting. Medical attention was sought. However, she regained consciousness after five minutes. She went home after the recovery. No further information was available at the time of reporting. Additional information has been requested. Additional infromation was received from a licensed vocational nurse. On 02-MAR-2007, at 5:15 PM after receiving the vaccination the patient stated that she felt lightheaded and fell forward and laid her head on the nurses shoulder. The patient then briefly had a "seizure like" motion of her head. The nurse laid her back on the table. The patient quickly resumed normal fucntion and stated she felt fine. The physician stated vasovagal episode. No additional information is expected.


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