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This is VAERS ID 277167

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

277167
VAERS Form:
Age:
Gender:Female
Location:Pennsylvania
Vaccinated:2007-04-01
Onset:2007-04-01
Submitted:2007-04-20
Entered:2007-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Convulsion, Gaze palsy

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: Unknown
CDC 'Split Type':

Write-up:Information has been received from a physician concerning a 12-15 year old (exact age unknown) female patient who in April 2007, was vaccinated with a dose of Gardasil. The patient started to convulse in front of the physician and her eyes rolled back aft"er receiving the Gardasil. The patient received medical attention. The physician''''s office followed up with the patient the next day and she was doing fine. Upon internal review, convulsion was considered to be an other important medical event. The physic


Changed on 12/8/2009

277167 Before After
VAERS Form:
Age:
Gender:Female
Location:Pennsylvania
Vaccinated:2007-04-01
Onset:2007-04-01
Submitted:2007-04-20
Entered:2007-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Convulsion, Gaze palsy

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: Unknown
CDC 'Split Type': (blank) WAES0704USA02668

Write-up:Information has been received from a physician concerning a 12-15 year old (exact age unknown) female patient who in April 2007, was vaccinated with a dose of Gardasil. The patient started to convulse in front of the physician and her eyes rolled back aft"er after receiving the Gardasil. The patient received medical attention. The physician''''s physician''s office followed up with the patient the next day and she was doing fine. Upon internal review, convulsion was considered to be an other important medical event. The physic physician reported that another patient in the same age group convulsed after receiving the Gardasil. Additional information has been requested.


Changed on 9/14/2017

277167 Before After
VAERS Form:(blank) 1
Age:
Gender:Female
Location:Pennsylvania
Vaccinated:2007-04-01
Onset:2007-04-01
Submitted:2007-04-20
Entered:2007-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UNK - / IM

Administered by: Other      Purchased by: Other
Symptoms: Convulsion, Gaze palsy

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: Unknown
CDC 'Split Type': WAES0704USA02668

Write-up:Information has been received from a physician concerning a 12-15 year old (exact age unknown) female patient who in April 2007, was vaccinated with a dose of Gardasil. The patient started to convulse in front of the physician and her eyes rolled back after receiving the Gardasil. The patient received medical attention. The physician''s office followed up with the patient the next day and she was doing fine. Upon internal review, convulsion was considered to be an other important medical event. The physician reported that another patient in the same age group convulsed after receiving the Gardasil. Additional information has been requested.


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