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This is VAERS ID 277498

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

277498
VAERS Form:
Age:16.0
Gender:Female
Location:Delaware
Vaccinated:2007-04-27
Onset:2007-04-27
Submitted:2007-04-27
Entered:2007-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0389U / - LA / -

Administered by: Private      Purchased by: Unknown
Symptoms: Head injury, Loss of consciousness

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: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Pt passed out after injection - Head injury obtained.


Changed on 9/14/2017

277498 Before After
VAERS Form:(blank) 1
Age:16.0
Gender:Female
Location:Delaware
Vaccinated:2007-04-27
Onset:2007-04-27
Submitted:2007-04-27
Entered:2007-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0389U / - UNK LA / -

Administered by: Private      Purchased by: Unknown
Symptoms: Head injury, Loss of consciousness

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: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Pt passed out after injection - Head injury obtained.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=277498&WAYBACKHISTORY=ON


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