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This is VAERS ID 276869

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

276869
VAERS Form:
Age:19.0
Gender:Female
Location:Ohio
Vaccinated:2007-03-20
Onset:2007-03-20
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0244U / 0 - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: 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)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: LOESTRIN
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up:Information has been received from a registered nurse concerning a 19 year old female who on 20 Mar-2007 was vaccinated with a 0.5 ml dose of Gardasil vaccine (yeast) (lot # 656051/0244U). Concomitant medication included ethinyl estradiol (+) norethindron"e acetate /"1/20 BCP''''s./" On 20-MAR-2007 the patient fainted after receiving a shot of the vaccine. The patient laid down, smelling salt used and was given juice and a granola bar. The patient had not eaten since the night before. Subsequently, the patie


Changed on 12/8/2009

276869 Before After
VAERS Form:
Age:19.0
Gender:Female
Location:Ohio
Vaccinated:2007-03-20
Onset:2007-03-20
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0244U / 0 - / IM

Administered by: Private      Purchased by: Unknown Other
Symptoms: 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)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: LOESTRIN
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': (blank) WAES0703USA04224

Write-up:Information has been received from a registered nurse concerning a 19 year old female who on 20 Mar-2007 was vaccinated with a 0.5 ml dose of Gardasil vaccine (yeast) (lot # 656051/0244U). Concomitant medication included ethinyl estradiol (+) norethindron"e norethindrone acetate /"1/20 BCP''''s./" "1/20 BCP''s." On 20-MAR-2007 the patient fainted after receiving a shot of the vaccine. The patient laid down, smelling salt used and was given juice and a granola bar. The patient had not eaten since the night before. Subsequently, the patie patient recovered in less than 5 minutes. No product quality complaint was involved. Additional information has been requested.


Changed on 9/14/2017

276869 Before After
VAERS Form:(blank) 1
Age:19.0
Gender:Female
Location:Ohio
Vaccinated:2007-03-20
Onset:2007-03-20
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0244U / 0 1 - / IM

Administered by: Private      Purchased by: Other
Symptoms: 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)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: LOESTRIN
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0703USA04224

Write-up:Information has been received from a registered nurse concerning a 19 year old female who on 20 Mar-2007 was vaccinated with a 0.5 ml dose of Gardasil vaccine (yeast) (lot # 656051/0244U). Concomitant medication included ethinyl estradiol (+) norethindrone acetate "1/20 BCP''s." On 20-MAR-2007 the patient fainted after receiving a shot of the vaccine. The patient laid down, smelling salt used and was given juice and a granola bar. The patient had not eaten since the night before. Subsequently, the patient recovered in less than 5 minutes. No product quality complaint was involved. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=276869&WAYBACKHISTORY=ON


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