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This is VAERS ID 279559

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

279559
VAERS Form:
Age:24.0
Gender:Female
Location:Unknown
Vaccinated:2007-04-23
Onset:2007-04-23
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 1 UN / UN

Administered by: Other      Purchased by: Unknown
Symptoms: 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Information has been received from a physician concerning a 24 year old female who on 23-APR-2007 was vaccinated with Gardasil (Lot# 657617/0384U). On 23-APR-2007 the patient fainted before receiving dose two. The patient recovered and received the second"dose that same day. Additional information has been requested.


Changed on 12/8/2009

279559 Before After
VAERS Form:
Age:24.0
Gender:Female
Location:Unknown
Vaccinated:2007-04-23
Onset:2007-04-23
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 1 UN / UN

Administered by: Other      Purchased by: Unknown Other
Symptoms: 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) WAES0704USA05279

Write-up:Information has been received from a physician concerning a 24 year old female who on 23-APR-2007 was vaccinated with Gardasil (Lot# 657617/0384U). On 23-APR-2007 the patient fainted before receiving dose two. The patient recovered and received the second"dose second dose that same day. Additional information has been requested.


Changed on 3/2/2010

279559 Before After
VAERS Form:
Age:24.0
Gender:Female
Location:Unknown
Vaccinated:2007-04-23
Onset:2007-04-23
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0704USA05279

Write-up:Information has been received from a physician concerning a 24 year old female who on 23-APR-2007 was vaccinated with Gardasil (Lot# 657617/0384U). On 23-APR-2007 the patient fainted before receiving dose two. The patient recovered and received the second dose that same day. Additional information has been requested. is not expected.


Changed on 6/14/2014

279559 Before After
VAERS Form:
Age:24.0
Gender:Female
Location:Unknown
Vaccinated:2007-04-23
Onset:2007-04-23
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0704USA05279

Write-up:Information has been received from a physician concerning a 24 year old female who on 23-APR-2007 was vaccinated with Gardasil (Lot# 657617/0384U). On 23-APR-2007 the patient fainted before receiving dose two. The patient recovered and received the second dose that same day. Additional information is not expected.


Changed on 5/14/2017

279559 Before After
VAERS Form:
Age:24.0
Gender:Female
Location:Unknown
Vaccinated:2007-04-23
Onset:2007-04-23
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0704USA05279

Write-up:Information has been received from a physician concerning a 24 year old female who on 23-APR-2007 was vaccinated with Gardasil (Lot# 657617/0384U). On 23-APR-2007 the patient fainted before receiving dose two. The patient recovered and received the second dose that same day. Additional information is not expected.


Changed on 9/14/2017

279559 Before After
VAERS Form:(blank) 1
Age:24.0
Gender:Female
Location:Unknown
Vaccinated:2007-04-23
Onset:2007-04-23
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 1 2 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0704USA05279

Write-up:Information has been received from a physician concerning a 24 year old female who on 23-APR-2007 was vaccinated with Gardasil (Lot# 657617/0384U). On 23-APR-2007 the patient fainted before receiving dose two. The patient recovered and received the second dose that same day. Additional information is not expected.


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