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This is VAERS ID 276815

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

276815
VAERS Form:
Age:13.0
Gender:Female
Location:Unknown
Vaccinated:2007-03-17
Onset:2007-03-17
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / - UN / UN

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

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

Write-up:Information has been received from a nurse concerning a 13 year old female patient who on 17-MAR-2007 was vaccinated with a dose of Gardasil, lot #655619/1427F. The nurse reported that she noticed that the syringe was leaking, and she couldn''''t quantify h"ow much vaccine was received. She added that several minutes after the injection, the patient felt a bit faint, but recovered with no specific intervention. No further information is available.


Changed on 12/8/2009

276815 Before After
VAERS Form:
Age:13.0
Gender:Female
Location:Unknown
Vaccinated:2007-03-17
Onset:2007-03-17
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / - UN / UN

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

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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': (blank) WAES0703USA03681

Write-up:Information has been received from a nurse concerning a 13 year old female patient who on 17-MAR-2007 was vaccinated with a dose of Gardasil, lot #655619/1427F. The nurse reported that she noticed that the syringe was leaking, and she couldn''''t couldn''t quantify h"ow how much vaccine was received. She added that several minutes after the injection, the patient felt a bit faint, but recovered with no specific intervention. No further information is available.


Changed on 9/14/2017

276815 Before After
VAERS Form:(blank) 1
Age:13.0
Gender:Female
Location:Unknown
Vaccinated:2007-03-17
Onset:2007-03-17
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / - UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Syncope, Underdose

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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0703USA03681

Write-up:Information has been received from a nurse concerning a 13 year old female patient who on 17-MAR-2007 was vaccinated with a dose of Gardasil, lot #655619/1427F. The nurse reported that she noticed that the syringe was leaking, and she couldn''t quantify how much vaccine was received. She added that several minutes after the injection, the patient felt a bit faint, but recovered with no specific intervention. No further information is available.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=276815&WAYBACKHISTORY=ON


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