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This is VAERS ID 279487

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 279487
Age:18.0
Gender:Female
Location:Virginia
Vaccinated:2007-04-17
Onset:2007-04-17
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Syncope

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type':

Write-up:Initial and follow-up information has been received from a Licensed Practical Nurse (L.P.N.) concerning an 18 year old female patient who on 17-APR-2007 was vaccinated IM in left deltoid with a first dose of Gardasil (lot # 0378U not valid). Concomitant t"herapy included cetirizine hydrochloride (ZYRTEC). On 17-APR-2007 the patient fainted in her chair soon after the administration of her first injection. She recovered quickly after she was placed on the floor and her legs were elevated. Additional informa


Changed on 12/8/2009

VAERS ID: 279487 Before After
Age:18.0
Gender:Female
Location:Virginia
Vaccinated:2007-04-17
Onset:2007-04-17
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Syncope

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type': (blank) WAES0704USA03925

Write-up:Initial and follow-up information has been received from a Licensed Practical Nurse (L.P.N.) concerning an 18 year old female patient who on 17-APR-2007 was vaccinated IM in left deltoid with a first dose of Gardasil (lot # 0378U not valid). Concomitant t"herapy therapy included cetirizine hydrochloride (ZYRTEC). On 17-APR-2007 the patient fainted in her chair soon after the administration of her first injection. She recovered quickly after she was placed on the floor and her legs were elevated. Additional informa information has been requested.


Changed on 3/2/2010

VAERS ID: 279487 Before After
Age:18.0
Gender:Female
Location:Virginia
Vaccinated:2007-04-17
Onset:2007-04-17
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Syncope

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec ZYRTEC
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0704USA03925

Write-up:This is in follow-up to report(s) previously submitted on 5/14/2007. Initial and follow-up information has been received from a Licensed Practical Nurse (L.P.N.) concerning an 18 year old female patient student with no pertinent medical history or drug reactions/allergies who on 17-APR-2007 at approximately 3:55 PM was vaccinated IM in left deltoid with a first dose of Gardasil (lot # 0378U not valid). Concomitant therapy included cetirizine hydrochloride (ZYRTEC). ZYRTEC. On 17-APR-2007 at approximately 4:00 the patient fainted in her chair soon after the administration of her first injection. She recovered quickly after she was placed on the floor and her legs were elevated. This is one of three reports from the same source. Additional information has been requested.


Changed on 6/14/2014

VAERS ID: 279487 Before After
Age:18.0
Gender:Female
Location:Virginia
Vaccinated:2007-04-17
Onset:2007-04-17
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Syncope

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ZYRTEC
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0704USA03925

Write-up:This is in follow-up to report(s) previously submitted on 5/14/2007. Initial and follow-up information has been received from a Licensed Practical Nurse (L.P.N.) concerning an 18 year old female student with no pertinent medical history or drug reactions/allergies who on 17-APR-2007 at approximately 3:55 PM was vaccinated IM in left deltoid with a first dose of Gardasil (lot # 0378U not valid). Concomitant therapy included ZYRTEC. On 17-APR-2007 at approximately 4:00 the patient fainted in her chair soon after the administration of her first injection. She recovered quickly after she was placed on the floor and her legs were elevated. This is one of three reports from the same source. Additional information has been requested.


Changed on 5/14/2017

VAERS ID: 279487 Before After
Age:18.0
Gender:Female
Location:Virginia
Vaccinated:2007-04-17
Onset:2007-04-17
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Syncope

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ZYRTEC
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0704USA03925

Write-up:This is in follow-up to report(s) previously submitted on 5/14/2007. Initial and follow-up information has been received from a Licensed Practical Nurse (L.P.N.) concerning an 18 year old female student with no pertinent medical history or drug reactions/allergies who on 17-APR-2007 at approximately 3:55 PM was vaccinated IM in left deltoid with a first dose of Gardasil (lot # 0378U not valid). Concomitant therapy included ZYRTEC. On 17-APR-2007 at approximately 4:00 the patient fainted in her chair soon after the administration of her first injection. She recovered quickly after she was placed on the floor and her legs were elevated. This is one of three reports from the same source. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=279487&WAYBACKHISTORY=ON


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