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This is VAERS ID 276804

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 276804
Age:16.0
Gender:Female
Location:New York
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. - / - - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Pallor

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Information has been received from a physician concerning a 16 year old female with no reported medical history who on 09-MAR-2007 was vaccinated with Gardasil intramuscularly. There was no concomitant medication. On 09-MAR-2007 the patient experienced a"pale face. Subsequently, the patient recovered from pale face. Additional information has been requested.


Changed on 12/8/2009

VAERS ID: 276804 Before After
Age:16.0
Gender:Female
Location:New York
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. - / - - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Pallor

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type': (blank) WAES0703USA03455

Write-up:Information has been received from a physician concerning a 16 year old female with no reported medical history who on 09-MAR-2007 was vaccinated with Gardasil intramuscularly. There was no concomitant medication. On 09-MAR-2007 the patient experienced a"pale a pale face. Subsequently, the patient recovered from pale face. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=276804&WAYBACKHISTORY=ON


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