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This is VAERS ID 276881

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

276881
VAERS Form:
Age:12.0
Gender:Female
Location:Tennessee
Vaccinated:2007-03-22
Onset:2007-03-22
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN

Administered by: Other      Purchased by: Unknown
Symptoms: Dizziness, Presyncope

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Unknown
CDC 'Split Type':

Write-up:Information has been received from a physician, via a company representative, concerning a 12 year old female patient, who on 22-MAR-2007 was vaccinated with a dose, 0.5ml, of Gardasil. The physician reported that on 22-MAR-2007, after the vaccination was"administered, the patient /"experienced dizziness and almost passed out./" At the time of the report, it was unknown if the patient had recovered. The patient sought unspecified medical attention. Additional information has been requested.


Changed on 12/8/2009

276881 Before After
VAERS Form:
Age:12.0
Gender:Female
Location:Tennessee
Vaccinated:2007-03-22
Onset:2007-03-22
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN

Administered by: Other      Purchased by: Unknown Other
Symptoms: Dizziness, Presyncope

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Unknown
CDC 'Split Type': (blank) WAES0703USA04477

Write-up:Information has been received from a physician, via a company representative, concerning a 12 year old female patient, who on 22-MAR-2007 was vaccinated with a dose, 0.5ml, of Gardasil. The physician reported that on 22-MAR-2007, after the vaccination was"administered, was administered, the patient /"experienced "experienced dizziness and almost passed out./" out." At the time of the report, it was unknown if the patient had recovered. The patient sought unspecified medical attention. Additional information has been requested.


Changed on 9/14/2017

276881 Before After
VAERS Form:(blank) 1
Age:12.0
Gender:Female
Location:Tennessee
Vaccinated:2007-03-22
Onset:2007-03-22
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Dizziness, Presyncope

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Unknown
CDC 'Split Type': WAES0703USA04477

Write-up:Information has been received from a physician, via a company representative, concerning a 12 year old female patient, who on 22-MAR-2007 was vaccinated with a dose, 0.5ml, of Gardasil. The physician reported that on 22-MAR-2007, after the vaccination was administered, the patient "experienced dizziness and almost passed out." At the time of the report, it was unknown if the patient had recovered. The patient sought unspecified medical attention. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=276881&WAYBACKHISTORY=ON


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