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This is VAERS ID 279507

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

279507
VAERS Form:
Age:13.0
Gender:Female
Location:Pennsylvania
Vaccinated:2007-04-19
Onset:0000-00-00
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: Asthenia, Dizziness

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type':

Write-up:Information has been received from a physician concerning a 13 year old female patient who on 19-APR-2007 was vaccinated with a dose of Gardasil. Patient developed dizziness and weakness after the vaccine was administered. Unspecified medical attention wa"s sought was unknown. Additional information has been requested.


Changed on 12/8/2009

279507 Before After
VAERS Form:
Age:13.0
Gender:Female
Location:Pennsylvania
Vaccinated:2007-04-19
Onset:0000-00-00
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: Asthenia, Dizziness

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': (blank) WAES0704USA04413

Write-up:Information has been received from a physician concerning a 13 year old female patient who on 19-APR-2007 was vaccinated with a dose of Gardasil. Patient developed dizziness and weakness after the vaccine was administered. Unspecified medical attention wa"s was sought was unknown. Additional information has been requested.


Changed on 9/14/2017

279507 Before After
VAERS Form:(blank) 1
Age:13.0
Gender:Female
Location:Pennsylvania
Vaccinated:2007-04-19
Onset:0000-00-00
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: Asthenia, Dizziness

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0704USA04413

Write-up:Information has been received from a physician concerning a 13 year old female patient who on 19-APR-2007 was vaccinated with a dose of Gardasil. Patient developed dizziness and weakness after the vaccine was administered. Unspecified medical attention was sought was unknown. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=279507&WAYBACKHISTORY=ON


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