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This is VAERS ID 279180

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

279180
VAERS Form:
Age:23.0
Gender:Female
Location:Pennsylvania
Vaccinated:2007-04-03
Onset:2007-04-03
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0245U / 0 - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: 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)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: hormonal contraceptives
Current Illness: Drug hypersensitivity
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type':

Write-up:Information has been received from a physician, via a company representative, concerning a 23 year old female patient with drug hypersensitivity to Wellbutrin who on 03-APR-2007 was vaccinated with the first dose, 0.5ml, IM, of Gardasil (Lot #656050/0245U"). Concomitant therapy included hormonal contraceptives (unspecified). On 03-APR-2007, after the vaccine was administered, the patient fainted, the patient confirmed that she had not had breakfast before the vaccination was given. The physician reported t


Changed on 12/8/2009

279180 Before After
VAERS Form:
Age:23.0
Gender:Female
Location:Pennsylvania
Vaccinated:2007-04-03
Onset:2007-04-03
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0245U / 0 - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: 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)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: hormonal contraceptives
Current Illness: Drug hypersensitivity
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': (blank) WAES0704USA01509

Write-up:Information has been received from a physician, via a company representative, concerning a 23 year old female patient with drug hypersensitivity to Wellbutrin who on 03-APR-2007 was vaccinated with the first dose, 0.5ml, IM, of Gardasil (Lot #656050/0245U"). #656050/0245U). Concomitant therapy included hormonal contraceptives (unspecified). On 03-APR-2007, after the vaccine was administered, the patient fainted, the patient confirmed that she had not had breakfast before the vaccination was given. The physician reported t that the patient recovered on the same day. The patient sought unspecified medical attention. Additional information has been requested.


Changed on 3/2/2010

279180 Before After
VAERS Form:
Age:23.0
Gender:Female
Location:Pennsylvania
Vaccinated:2007-04-03
Onset:2007-04-03
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0245U / 0 - / IM

Administered by: Other Private      Purchased by: Other Private
Symptoms: 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)? Yes No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: hormonal contraceptives
Current Illness: Drug hypersensitivity hypersensitivity; Seasonal allergy; Dermatitis contact
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0704USA01509

Write-up:Information has been received from a physician, via a company representative, concerning a 23 year old female patient with drug hypersensitivity to Wellbutrin who on 03-APR-2007 was vaccinated with the first dose, 0.5ml, IM, of Gardasil (Lot #656050/0245U). Concomitant therapy included hormonal contraceptives (unspecified). On 03-APR-2007, after the vaccine was administered, the patient fainted, the patient confirmed that she had not had breakfast before the vaccination was given. The physician reported that the patient recovered on the same day. The patient sought unspecified medical attention. Additional information has been requested. 07/06/07 This is in follow-up to report(s) previously submitted on 5/14/2007. Initial and follow up information has been received from a physician, concerning a 23 year old female patient with drug hypersensitivity to WELLBUTRIN, contact dermatitis and seasonal allergies, who on 03-APR-2007 was vaccinated with the first dose, 0.5ml, IM, of GARDASIL (Lot #656050/0245U). Concomitant therapy included hormonal contraceptives (unspecified). On 03-APR-2007, after the vaccine was administered, the patient felt dizzy and "had a syncopal episode". The patient, who confirmed that she had not had breakfast before the vaccination was given, was moved to the exam room, monitored and given a drink. The physician reported that the patient recovered "within a half hour". No further information is expected.


Changed on 4/7/2010

279180 Before After
VAERS Form:
Age:23.0
Gender:Female
Location:Pennsylvania
Vaccinated:2007-04-03
Onset:2007-04-03
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0245U / 0 - / IM

Administered by: Private      Purchased by: Private
Symptoms: 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: hormonal contraceptives
Current Illness: Drug hypersensitivity; Seasonal allergy; Dermatitis contact
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0704USA01509

Write-up:Information has been received from a physician, via a company representative, concerning a 23 year old female patient with drug hypersensitivity to Wellbutrin who on 03-APR-2007 was vaccinated with the first dose, 0.5ml, IM, of Gardasil (Lot #656050/0245U). Concomitant therapy included hormonal contraceptives (unspecified). On 03-APR-2007, after the vaccine was administered, the patient fainted, the patient confirmed that she had not had breakfast before the vaccination was given. The physician reported that the patient recovered on the same day. The patient sought unspecified medical attention. Additional information has been requested. 07/06/07 This is in follow-up to report(s) previously submitted on 5/14/2007. Initial and follow up information has been received from a physician, concerning a 23 year old female patient with drug hypersensitivity to WELLBUTRIN, contact dermatitis and seasonal allergies, who on 03-APR-2007 was vaccinated with the first dose, 0.5ml, IM, of GARDASIL (Lot #656050/0245U). Concomitant therapy included hormonal contraceptives (unspecified). On 03-APR-2007, after the vaccine was administered, the patient felt dizzy and "had a syncopal episode". The patient, who confirmed that she had not had breakfast before the vaccination was given, was moved to the exam room, monitored and given a drink. The physician reported that the patient recovered "within a half hour". No further information is expected.


Changed on 6/14/2014

279180 Before After
VAERS Form:
Age:23.0
Gender:Female
Location:Pennsylvania
Vaccinated:2007-04-03
Onset:2007-04-03
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0245U / 0 - / IM

Administered by: Private      Purchased by: Private
Symptoms: 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: hormonal contraceptives
Current Illness: Drug hypersensitivity; Seasonal allergy; Dermatitis contact
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0704USA01509

Write-up:Information has been received from a physician, via a company representative, concerning a 23 year old female patient with drug hypersensitivity to Wellbutrin who on 03-APR-2007 was vaccinated with the first dose, 0.5ml, IM, of Gardasil (Lot #656050/0245U). Concomitant therapy included hormonal contraceptives (unspecified). On 03-APR-2007, after the vaccine was administered, the patient fainted, the patient confirmed that she had not had breakfast before the vaccination was given. The physician reported that the patient recovered on the same day. The patient sought unspecified medical attention. Additional information has been requested. 07/06/07 This is in follow-up to report(s) previously submitted on 5/14/2007. Initial and follow up information has been received from a physician, concerning a 23 year old female patient with drug hypersensitivity to WELLBUTRIN, contact dermatitis and seasonal allergies, who on 03-APR-2007 was vaccinated with the first dose, 0.5ml, IM, of GARDASIL (Lot #656050/0245U). Concomitant therapy included hormonal contraceptives (unspecified). On 03-APR-2007, after the vaccine was administered, the patient felt dizzy and "had a syncopal episode". The patient, who confirmed that she had not had breakfast before the vaccination was given, was moved to the exam room, monitored and given a drink. The physician reported that the patient recovered "within a half hour". No further information is expected.


Changed on 5/14/2017

279180 Before After
VAERS Form:
Age:23.0
Gender:Female
Location:Pennsylvania
Vaccinated:2007-04-03
Onset:2007-04-03
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0245U / 0 - / IM

Administered by: Private      Purchased by: Private
Symptoms: 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: hormonal contraceptives
Current Illness: Drug hypersensitivity; Seasonal allergy; Dermatitis contact
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0704USA01509

Write-up:Information has been received from a physician, via a company representative, concerning a 23 year old female patient with drug hypersensitivity to Wellbutrin who on 03-APR-2007 was vaccinated with the first dose, 0.5ml, IM, of Gardasil (Lot #656050/0245U). Concomitant therapy included hormonal contraceptives (unspecified). On 03-APR-2007, after the vaccine was administered, the patient fainted, the patient confirmed that she had not had breakfast before the vaccination was given. The physician reported that the patient recovered on the same day. The patient sought unspecified medical attention. Additional information has been requested. 07/06/07 This is in follow-up to report(s) previously submitted on 5/14/2007. Initial and follow up information has been received from a physician, concerning a 23 year old female patient with drug hypersensitivity to WELLBUTRIN, contact dermatitis and seasonal allergies, who on 03-APR-2007 was vaccinated with the first dose, 0.5ml, IM, of GARDASIL (Lot #656050/0245U). Concomitant therapy included hormonal contraceptives (unspecified). On 03-APR-2007, after the vaccine was administered, the patient felt dizzy and "had a syncopal episode". The patient, who confirmed that she had not had breakfast before the vaccination was given, was moved to the exam room, monitored and given a drink. The physician reported that the patient recovered "within a half hour". No further information is expected.


Changed on 9/14/2017

279180 Before After
VAERS Form:(blank) 1
Age:23.0
Gender:Female
Location:Pennsylvania
Vaccinated:2007-04-03
Onset:2007-04-03
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0245U / 0 1 - / IM

Administered by: Private      Purchased by: Private
Symptoms: 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: hormonal contraceptives
Current Illness: Drug hypersensitivity; Seasonal allergy; Dermatitis contact
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0704USA01509

Write-up:Information has been received from a physician, via a company representative, concerning a 23 year old female patient with drug hypersensitivity to Wellbutrin who on 03-APR-2007 was vaccinated with the first dose, 0.5ml, IM, of Gardasil (Lot #656050/0245U). Concomitant therapy included hormonal contraceptives (unspecified). On 03-APR-2007, after the vaccine was administered, the patient fainted, the patient confirmed that she had not had breakfast before the vaccination was given. The physician reported that the patient recovered on the same day. The patient sought unspecified medical attention. Additional information has been requested. 07/06/07 This is in follow-up to report(s) previously submitted on 5/14/2007. Initial and follow up information has been received from a physician, concerning a 23 year old female patient with drug hypersensitivity to WELLBUTRIN, contact dermatitis and seasonal allergies, who on 03-APR-2007 was vaccinated with the first dose, 0.5ml, IM, of GARDASIL (Lot #656050/0245U). Concomitant therapy included hormonal contraceptives (unspecified). On 03-APR-2007, after the vaccine was administered, the patient felt dizzy and "had a syncopal episode". The patient, who confirmed that she had not had breakfast before the vaccination was given, was moved to the exam room, monitored and given a drink. The physician reported that the patient recovered "within a half hour". No further information is expected.


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