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This is VAERS ID 278505

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

278505
VAERS Form:
Age:18.0
Gender:Female
Location:Texas
Vaccinated:2007-05-14
Onset:2007-05-14
Submitted:2007-05-14
Entered:2007-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1424F / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U2171AA / 0 LA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Cold sweat, Dizziness, 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)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NKDA
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Pt C/O feeling dizzy, pt fainted, skin cold and clammy; pt regained consciousness and vital were within normal range; pt rested with a cold pack to her forehead.


Changed on 12/8/2009

278505 Before After
VAERS Form:
Age:18.0
Gender:Female
Location:Texas
Vaccinated:2007-05-14
Onset:2007-05-14
Submitted:2007-05-14
Entered:2007-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1424F / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U2171AA / 0 LA / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Cold sweat, Dizziness, 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)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NKDA
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Pt C/O feeling dizzy, pt fainted, skin cold and clammy; pt regained consciousness and vital were within normal range; pt rested with a cold pack to her forehead.


Changed on 4/7/2010

278505 Before After
VAERS Form:
Age:18.0
Gender:Female
Location:Texas
Vaccinated:2007-05-14
Onset:2007-05-14
Submitted:2007-05-14
Entered:2007-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1424F / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2171AA / 0 LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Cold sweat, Dizziness, 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)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NKDA
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Pt C/O feeling dizzy, pt fainted, skin cold and clammy; pt regained consciousness and vital were within normal range; pt rested with a cold pack to her forehead.


Changed on 9/14/2017

278505 Before After
VAERS Form:(blank) 1
Age:18.0
Gender:Female
Location:Texas
Vaccinated:2007-05-14
Onset:2007-05-14
Submitted:2007-05-14
Entered:2007-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1424F / 0 1 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2171AA / 0 1 LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Cold sweat, Dizziness, 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)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NKDA
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Pt C/O feeling dizzy, pt fainted, skin cold and clammy; pt regained consciousness and vital were within normal range; pt rested with a cold pack to her forehead.


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