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This is VAERS ID 279171

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 279171
Age:20.0
Gender:Female
Location:Unknown
Vaccinated:2007-03-29
Onset:2007-03-29
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0243U / 0 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Blood pressure, Dizziness, Drug administered at inappropriate site, Stomach discomfort

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Sulfonamide allergy; House dust allergy; Mycotic allergy
Preexisting Conditions:
Diagnostic Lab Data: blood pressure 03/29/07 117/8 total heartbeat count 03/29/07 63
CDC 'Split Type':

Write-up:Information has been received from a registered nurse concerning a 20 year old female patient with allergies to Sulfa, dust and mold who on 29-MAR-2007 was vaccinated IM into the left deltoid (previously reported as gluteus) with a first dose of Gardasil"(lot # 656372/0243U). The patient became faint after the injection, but did not lose consciousness. The patient put her head down, used a cool cloth, spirits of ammonia and laid down in the exam table. The patient was give apple juice. The patient''''s bloo


Changed on 12/8/2009

VAERS ID: 279171 Before After
Age:20.0
Gender:Female
Location:Unknown
Vaccinated:2007-03-29
Onset:2007-03-29
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0243U / 0 LA / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Blood pressure, Dizziness, Drug administered at inappropriate site, Stomach discomfort

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Sulfonamide allergy; House dust allergy; Mycotic allergy
Preexisting Conditions:
Diagnostic Lab Data: blood pressure 03/29/07 117/8 total heartbeat count 03/29/07 63
CDC 'Split Type': (blank) WAES0704USA01288

Write-up:Information has been received from a registered nurse concerning a 20 year old female patient with allergies to Sulfa, dust and mold who on 29-MAR-2007 was vaccinated IM into the left deltoid (previously reported as gluteus) with a first dose of Gardasil"(lot Gardasil (lot # 656372/0243U). The patient became faint after the injection, but did not lose consciousness. The patient put her head down, used a cool cloth, spirits of ammonia and laid down in the exam table. The patient was give apple juice. The patient''''s bloo patient''s blood pressure was 117/86 with a pulse of 63. On 30-MAR-2007, the patient returned to the office and stated that she had felt woosy and experienced a sensitive stomach the 24 hours following the vaccination. The patient recovered from her experience on 30-MAR-2007. No product quality complaint was involved. Additional information is not expected.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=279171&WAYBACKHISTORY=ON


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