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This is VAERS ID 279533

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

279533
VAERS Form:
Age:
Gender:Female
Location:New Hampshire
Vaccinated:0000-00-00
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 / IM
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / UN

Administered by: Other      Purchased by: Unknown
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)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up:Information has been received from a physician concerning a female between 11 and 18 years old (exact age unspecified) who, on an unspecified date, was vaccinated intramuscularly with a 0.5 mL dose of Gardasil. Subsequently, on and unspecified date, the p"atient felt dizzy and fainted. It was noted that the patient received at least one other vaccine on the same date as when Gardasil was administered. The patient sought unspecified medical attention. No laboratory diagnostic studies were performed. The pat


Changed on 12/8/2009

279533 Before After
VAERS Form:
Age:
Gender:Female
Location:New Hampshire
Vaccinated:0000-00-00
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 / IM
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / UN

Administered by: Other      Purchased by: Unknown Other
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)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': (blank) WAES0704USA04858

Write-up:Information has been received from a physician concerning a female between 11 and 18 years old (exact age unspecified) who, on an unspecified date, was vaccinated intramuscularly with a 0.5 mL dose of Gardasil. Subsequently, on and unspecified date, the p"atient patient felt dizzy and fainted. It was noted that the patient received at least one other vaccine on the same date as when Gardasil was administered. The patient sought unspecified medical attention. No laboratory diagnostic studies were performed. The pat patient recovered on the same day as when the injection was given. No product quality complaint was involved. This is one of several reports received from the same source. Additional information has been requested.


Changed on 3/2/2010

279533 Before After
VAERS Form:
Age:(blank) 15.0
Gender:Female
Location:New Hampshire
Vaccinated:0000-00-00 2007-03-26
Onset:0000-00-00 2007-03-26
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - 1425F / - 0 UN LA / IM
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / UN

Administered by: Other Private      Purchased by: Other Public
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)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown Unknown; None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0704USA04858

Write-up:Information has been received from a physician concerning a female between 11 and 18 years old (exact age unspecified) who, on an unspecified date, was vaccinated intramuscularly with a 0.5 mL dose of Gardasil. Subsequently, on and unspecified date, the patient felt dizzy and fainted. It was noted that the patient received at least one other vaccine on the same date as when Gardasil was administered. The patient sought unspecified medical attention. No laboratory diagnostic studies were performed. The patient recovered on the same day as when the injection was given. No product quality complaint was involved. This is one of several reports received from the same source. Additional information has been requested. 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 15 year old female student with no drug allergies and no medical history who, on 26-MAR-2007 at approximately 14:30 was vaccinated intramuscularly in the left deltoid with a 0.5 mL first dose of GARDASIL (Lot# 655165/1425F). Subsequently, the patient felt very dirry (it was previously reported that the patient had fainted) which was not noted by staff but witnessed by the patient''s mom. The patient noted that she sat on the exam table for a while and felt better. It was noted that the patient received at least one other vaccine on the same date was when GARDASIL was administered. The patient sought unspecified medical attention. No laboratory diagnostic studies were performed and there were no illnesses at the time of vaccination. The patient recovered on 26-MAR-2007. On 11-JUL-2007 the patient was vaccinated with a second dose of GARDASIL. The patient layed on the exam table for five minutes and no adverse effects were reported after the second dose. No product quality complaint was involved. This is on of several reports received from the same source. Additional information is not expected.


Changed on 4/7/2010

279533 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:New Hampshire
Vaccinated:2007-03-26
Onset:2007-03-26
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1425F / 0 LA / IM
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / UN

Administered by: Private      Purchased by: Public
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)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown; None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0704USA04858

Write-up:Information has been received from a physician concerning a female between 11 and 18 years old (exact age unspecified) who, on an unspecified date, was vaccinated intramuscularly with a 0.5 mL dose of Gardasil. Subsequently, on and unspecified date, the patient felt dizzy and fainted. It was noted that the patient received at least one other vaccine on the same date as when Gardasil was administered. The patient sought unspecified medical attention. No laboratory diagnostic studies were performed. The patient recovered on the same day as when the injection was given. No product quality complaint was involved. This is one of several reports received from the same source. Additional information has been requested. 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 15 year old female student with no drug allergies and no medical history who, on 26-MAR-2007 at approximately 14:30 was vaccinated intramuscularly in the left deltoid with a 0.5 mL first dose of GARDASIL (Lot# 655165/1425F). Subsequently, the patient felt very dirry (it was previously reported that the patient had fainted) which was not noted by staff but witnessed by the patient''s mom. The patient noted that she sat on the exam table for a while and felt better. It was noted that the patient received at least one other vaccine on the same date was when GARDASIL was administered. The patient sought unspecified medical attention. No laboratory diagnostic studies were performed and there were no illnesses at the time of vaccination. The patient recovered on 26-MAR-2007. On 11-JUL-2007 the patient was vaccinated with a second dose of GARDASIL. The patient layed on the exam table for five minutes and no adverse effects were reported after the second dose. No product quality complaint was involved. This is on of several reports received from the same source. Additional information is not expected.


Changed on 9/14/2017

279533 Before After
VAERS Form:(blank) 1
Age:15.0
Gender:Female
Location:New Hampshire
Vaccinated:2007-03-26
Onset:2007-03-26
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1425F / 0 1 LA / IM
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK UN / UN

Administered by: Private      Purchased by: Public
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)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown; None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0704USA04858

Write-up:Information has been received from a physician concerning a female between 11 and 18 years old (exact age unspecified) who, on an unspecified date, was vaccinated intramuscularly with a 0.5 mL dose of Gardasil. Subsequently, on and unspecified date, the patient felt dizzy and fainted. It was noted that the patient received at least one other vaccine on the same date as when Gardasil was administered. The patient sought unspecified medical attention. No laboratory diagnostic studies were performed. The patient recovered on the same day as when the injection was given. No product quality complaint was involved. This is one of several reports received from the same source. Additional information has been requested. 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 15 year old female student with no drug allergies and no medical history who, on 26-MAR-2007 at approximately 14:30 was vaccinated intramuscularly in the left deltoid with a 0.5 mL first dose of GARDASIL (Lot# 655165/1425F). Subsequently, the patient felt very dirry (it was previously reported that the patient had fainted) which was not noted by staff but witnessed by the patient''s mom. The patient noted that she sat on the exam table for a while and felt better. It was noted that the patient received at least one other vaccine on the same date was when GARDASIL was administered. The patient sought unspecified medical attention. No laboratory diagnostic studies were performed and there were no illnesses at the time of vaccination. The patient recovered on 26-MAR-2007. On 11-JUL-2007 the patient was vaccinated with a second dose of GARDASIL. The patient layed on the exam table for five minutes and no adverse effects were reported after the second dose. No product quality complaint was involved. This is on of several reports received from the same source. Additional information is not expected.


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