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This is VAERS ID 278603

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

278603
VAERS Form:
Age:18.0
Gender:Female
Location:Florida
Vaccinated:2007-03-14
Onset:2007-03-14
Submitted:2007-05-08
Entered:2007-05-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0186U / 0 RA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Loss of consciousness, Pallor

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: none
Preexisting Conditions: Allergy to Clindamycin
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up:After injection of Gardasil vaccine 0.5 ml, Pt was sitting talking to her mother. She became pale and passed out for a few minutes. She was revived and walked to exam table. After lying down for 15-20 min.-left the office doing well.


Changed on 12/8/2009

278603 Before After
VAERS Form:
Age:18.0
Gender:Female
Location:Florida
Vaccinated:2007-03-14
Onset:2007-03-14
Submitted:2007-05-08
Entered:2007-05-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0186U / 0 RA / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Loss of consciousness, Pallor

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: none
Preexisting Conditions: Allergy to Clindamycin
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up:After injection of Gardasil vaccine 0.5 ml, Pt was sitting talking to her mother. She became pale and passed out for a few minutes. She was revived and walked to exam table. After lying down for 15-20 min.-left the office doing well.


Changed on 9/14/2017

278603 Before After
VAERS Form:(blank) 1
Age:18.0
Gender:Female
Location:Florida
Vaccinated:2007-03-14
Onset:2007-03-14
Submitted:2007-05-08
Entered:2007-05-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0186U / 0 1 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Loss of consciousness, Pallor

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: none
Preexisting Conditions: Allergy to Clindamycin
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up:After injection of Gardasil vaccine 0.5 ml, Pt was sitting talking to her mother. She became pale and passed out for a few minutes. She was revived and walked to exam table. After lying down for 15-20 min.-left the office doing well.


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