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This is VAERS ID 276838

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

276838
VAERS Form:
Age:18.0
Gender:Female
Location:Massachusetts
Vaccinated:2007-01-08
Onset:2007-01-08
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Other      Purchased by: Unknown
Symptoms: Loss of consciousness

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:
CDC 'Split Type':

Write-up:Information has been received from a physician, via a company representative, concerning an 18 year old female patient who on 08-JAN-2007 was vaccinated with the first dose, 0.5 of Gardasil, and on approximately 08-MAR-2007 (/"two months later/") was vacc"inated with the second dose, 0.5 ml, of Gardasil. The physician reported that on 08-JAN-2007, soon after receiving the first vaccination, the patient passed out, /"she recovered after a short while in the physician office./" Following the second vaccinati


Changed on 12/8/2009

276838 Before After
VAERS Form:
Age:18.0
Gender:Female
Location:Massachusetts
Vaccinated:2007-01-08
Onset:2007-01-08
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Other      Purchased by: Unknown Other
Symptoms: Loss of consciousness

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:
CDC 'Split Type': (blank) WAES0703USA03921

Write-up:Information has been received from a physician, via a company representative, concerning an 18 year old female patient who on 08-JAN-2007 was vaccinated with the first dose, 0.5 of Gardasil, and on approximately 08-MAR-2007 (/"two ("two months later/") later") was vacc"inated vaccinated with the second dose, 0.5 ml, of Gardasil. The physician reported that on 08-JAN-2007, soon after receiving the first vaccination, the patient passed out, /"she "she recovered after a short while in the physician office./" office." Following the second vaccinati vaccination, the physician reported the patient "had no ill effects". Additional information has been requested.


Changed on 9/14/2017

276838 Before After
VAERS Form:(blank) 1
Age:18.0
Gender:Female
Location:Massachusetts
Vaccinated:2007-01-08
Onset:2007-01-08
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 2 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Loss of consciousness

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:
CDC 'Split Type': WAES0703USA03921

Write-up:Information has been received from a physician, via a company representative, concerning an 18 year old female patient who on 08-JAN-2007 was vaccinated with the first dose, 0.5 of Gardasil, and on approximately 08-MAR-2007 ("two months later") was vaccinated with the second dose, 0.5 ml, of Gardasil. The physician reported that on 08-JAN-2007, soon after receiving the first vaccination, the patient passed out, "she recovered after a short while in the physician office." Following the second vaccination, the physician reported the patient "had no ill effects". Additional information has been requested.


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