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This is VAERS ID 279276

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

279276
VAERS Form:
Age:15.0
Gender:Female
Location:New York
Vaccinated:2007-05-19
Onset:2007-05-19
Submitted:2007-05-19
Entered:2007-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U2277AA / 0 RA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Syncope, Musculoskeletal stiffness

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: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Syncope - lasting 15 seconds (with stiffening but no seizures) resolved spontaneously with conservative care (lying down).


Changed on 12/8/2009

279276 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:New York
Vaccinated:2007-05-19
Onset:2007-05-19
Submitted:2007-05-19
Entered:2007-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U2277AA / 0 RA / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Syncope, Musculoskeletal stiffness

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: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Syncope - lasting 15 seconds (with stiffening but no seizures) resolved spontaneously with conservative care (lying down).


Changed on 4/7/2010

279276 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:New York
Vaccinated:2007-05-19
Onset:2007-05-19
Submitted:2007-05-19
Entered:2007-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2277AA / 0 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Syncope, Musculoskeletal stiffness

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: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Syncope - lasting 15 seconds (with stiffening but no seizures) resolved spontaneously with conservative care (lying down).


Changed on 9/14/2017

279276 Before After
VAERS Form:(blank) 1
Age:15.0
Gender:Female
Location:New York
Vaccinated:2007-05-19
Onset:2007-05-19
Submitted:2007-05-19
Entered:2007-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 0 1 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2277AA / 0 1 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Syncope, Musculoskeletal stiffness

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: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Syncope - lasting 15 seconds (with stiffening but no seizures) resolved spontaneously with conservative care (lying down).


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=279276&WAYBACKHISTORY=ON


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