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This is VAERS ID 279017

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 279017
Age:16.0
Gender:Female
Location:Washington
Vaccinated:2007-05-16
Onset:2007-05-16
Submitted:2007-05-18
Entered:2007-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0246U / 0 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0171U / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U2223AA / 0 GM / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B015BA / 0 RA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Grand mal convulsion, Loss of consciousness

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: pt. complained of dizziness for last 5 days
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:A few seconds after the vaccines were administered the pt. passed out and then had tonic clonic seizure lasting approx. 1 minute.


Changed on 12/8/2009

VAERS ID: 279017 Before After
Age:16.0
Gender:Female
Location:Washington
Vaccinated:2007-05-16
Onset:2007-05-16
Submitted:2007-05-18
Entered:2007-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0246U / 0 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0171U / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U2223AA / 0 GM / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B015BA / 0 RA / IM

Administered by: Private      Purchased by: Unknown Public
Symptoms: Grand mal convulsion, Loss of consciousness

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: pt. complained of dizziness for last 5 days
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:A few seconds after the vaccines were administered the pt. passed out and then had tonic clonic seizure lasting approx. 1 minute.


Changed on 4/7/2010

VAERS ID: 279017 Before After
Age:16.0
Gender:Female
Location:Washington
Vaccinated:2007-05-16
Onset:2007-05-16
Submitted:2007-05-18
Entered:2007-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0246U / 0 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0171U / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2223AA / 0 GM / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B015BA / 0 RA / IM

Administered by: Private      Purchased by: Public
Symptoms: Grand mal convulsion, Loss of consciousness

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: pt. complained of dizziness for last 5 days
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:A few seconds after the vaccines were administered the pt. passed out and then had tonic clonic seizure lasting approx. 1 minute.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=279017&WAYBACKHISTORY=ON


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