National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 279125

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

279125
VAERS Form:
Age:12.0
Gender:Female
Location:Rhode Island
Vaccinated:2007-05-14
Onset:2007-05-14
Submitted:2007-05-15
Entered:2007-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 1 - / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Malaise, 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: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up:Child received Gardasil - within 3-4 minutes stated /"I don''''t feel good/" - within 7-8 minutes after injection, child fainted to the floor. Child woke right away.


Changed on 12/8/2009

279125 Before After
VAERS Form:
Age:12.0
Gender:Female
Location:Rhode Island
Vaccinated:2007-05-14
Onset:2007-05-14
Submitted:2007-05-15
Entered:2007-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 1 - / IM

Administered by: Public      Purchased by: Unknown Public
Symptoms: Malaise, 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: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up:Child received Gardasil - within 3-4 minutes stated /"I don''''t "I don''t feel good/" good" - within 7-8 minutes after injection, child fainted to the floor. Child woke right away.


Changed on 9/14/2017

279125 Before After
VAERS Form:(blank) 1
Age:12.0
Gender:Female
Location:Rhode Island
Vaccinated:2007-05-14
Onset:2007-05-14
Submitted:2007-05-15
Entered:2007-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 1 2 - / IM

Administered by: Public      Purchased by: Public
Symptoms: Malaise, 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: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up:Child received Gardasil - within 3-4 minutes stated "I don''t feel good" - within 7-8 minutes after injection, child fainted to the floor. Child woke right away.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=279125&WAYBACKHISTORY=ON


Copyright © 2017 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166