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This is VAERS ID 279211

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

279211
VAERS Form:
Age:16.0
Gender:Female
Location:Unknown
Vaccinated:2007-03-23
Onset:2007-03-23
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN

Administered by: Other      Purchased by: Unknown
Symptoms: Fall, Injection site pain, 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: Unk
Current Illness:
Preexisting Conditions: Unk
Allergies:
Diagnostic Lab Data: Unk
CDC 'Split Type':

Write-up:Information has been received from the mother concerning her 16 year old daughter who on 23-MAR-2007 was vaccinated with Gardasil. The patient fainted a few minutes after being vaccinated. No injury was noted due to the fall. The patient also stated that"the vaccination was very painful. Medical attention was sought. At the time of reporting, the patient had recovered. No further information was available at the time of reporting. Additional information has been requested.


Changed on 12/8/2009

279211 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Unknown
Vaccinated:2007-03-23
Onset:2007-03-23
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN

Administered by: Other      Purchased by: Unknown Other
Symptoms: Fall, Injection site pain, 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: Unk
Current Illness:
Preexisting Conditions: Unk
Allergies:
Diagnostic Lab Data: Unk
CDC 'Split Type': (blank) WAES0704USA02541

Write-up:Information has been received from the mother concerning her 16 year old daughter who on 23-MAR-2007 was vaccinated with Gardasil. The patient fainted a few minutes after being vaccinated. No injury was noted due to the fall. The patient also stated that"the that the vaccination was very painful. Medical attention was sought. At the time of reporting, the patient had recovered. No further information was available at the time of reporting. Additional information has been requested.


Changed on 9/14/2017

279211 Before After
VAERS Form:(blank) 1
Age:16.0
Gender:Female
Location:Unknown
Vaccinated:2007-03-23
Onset:2007-03-23
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Fall, Injection site pain, 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: Unk
Current Illness:
Preexisting Conditions: Unk
Allergies:
Diagnostic Lab Data: Unk
CDC 'Split Type': WAES0704USA02541

Write-up:Information has been received from the mother concerning her 16 year old daughter who on 23-MAR-2007 was vaccinated with Gardasil. The patient fainted a few minutes after being vaccinated. No injury was noted due to the fall. The patient also stated that the vaccination was very painful. Medical attention was sought. At the time of reporting, the patient had recovered. No further information was available at the time of reporting. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=279211&WAYBACKHISTORY=ON


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