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This is VAERS ID 279667

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 279667
Age:14.0
Gender:Female
Location:Missouri
Vaccinated:2007-04-11
Onset:2007-04-11
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: Syncope

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

Write-up:Information has been received from a physician concerning a 14 female who on 11-APR-2007 was vaccinated with a 0.5 mL dose of Gardasil (Lot # /"03874/"). Subsequently, the patient fainted 5 minutes after receiving the Gardasil. At the time of this report,"the patient had recovered. No product quality complaint was involved. Additional information has been requested.


Changed on 12/8/2009

VAERS ID: 279667 Before After
Age:14.0
Gender:Female
Location:Missouri
Vaccinated:2007-04-11
Onset:2007-04-11
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: Syncope

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type': (blank) WAES0705USA00170

Write-up:Information has been received from a physician concerning a 14 female who on 11-APR-2007 was vaccinated with a 0.5 mL dose of Gardasil (Lot # /"03874/"). "03874"). Subsequently, the patient fainted 5 minutes after receiving the Gardasil. At the time of this report,"the report, the patient had recovered. No product quality complaint was involved. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=279667&WAYBACKHISTORY=ON


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