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This is VAERS ID 279670

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

279670
VAERS Form:
Age:17.0
Gender:Female
Location:Texas
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. - / 0 - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Syncope

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, via company representative, concerning a 17 year old female patient who was vaccinated IM (date unspecified), with the first dose of Gardasil. The physician reported that the patient /"fainted in the office"waiting room shortly after being vaccinated./" The physician stated the patient was presumed to be doing fine, though she had not heard from the patient. The patient sought unspecified medical attention. Additional information has been requested.


Changed on 12/8/2009

279670 Before After
VAERS Form:
Age:17.0
Gender:Female
Location:Texas
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. - / 0 - / IM

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

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) WAES0705USA00372

Write-up:Information has been received from a physician, via company representative, concerning a 17 year old female patient who was vaccinated IM (date unspecified), with the first dose of Gardasil. The physician reported that the patient /"fainted "fainted in the office"waiting office waiting room shortly after being vaccinated./" vaccinated." The physician stated the patient was presumed to be doing fine, though she had not heard from the patient. The patient sought unspecified medical attention. Additional information has been requested.


Changed on 2/5/2010

279670 Before After
VAERS Form:
Age:17.0
Gender:Female
Location:Texas
Vaccinated:0000-00-00 2007-01-04
Onset:0000-00-00
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - 1425F / 0 - UN / IM

Administered by: Other Private      Purchased by: Other Private
Symptoms: Syncope

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 No
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': WAES0705USA00372

Write-up:Information has been received from a physician, via a company representative, concerning a 17 year old female patient who was vaccinated IM (date unspecified), with the first dose of Gardasil. The physician reported that the patient "fainted in the office waiting room shortly after being vaccinated." The physician stated the patient was presumed to be doing fine, though she had not heard from the patient. The patient sought unspecified medical attention. 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 froma physician, concerning a 17 year old female patient, with no known drug allergies, who on 04-JAN-2007, was vaccinated IM in the lteft arm, with the first dose of GARDASIL (Lot #655165/1425F). Follow up information added that the patient had developed an area of induration at the site of injection (date of onset not specified). The physician indicated that the patient did not require an office visit or other treatment. At the time of this report, the outcome of both events was unknown. Additional information has neem requested.


Changed on 6/14/2014

279670 Before After
VAERS Form:
Age:17.0
Gender:Female
Location:Texas
Vaccinated:2007-01-04
Onset:0000-00-00
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1425F / 0 UN / IM

Administered by: Private      Purchased by: Private
Symptoms: Syncope

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
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': WAES0705USA00372

Write-up:Information has been received from a physician, via a company representative, concerning a 17 year old female patient who was vaccinated IM (date unspecified), with the first dose of Gardasil. The physician reported that the patient "fainted in the office waiting room shortly after being vaccinated." The physician stated the patient was presumed to be doing fine, though she had not heard from the patient. The patient sought unspecified medical attention. 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 froma physician, concerning a 17 year old female patient, with no known drug allergies, who on 04-JAN-2007, was vaccinated IM in the lteft arm, with the first dose of GARDASIL (Lot #655165/1425F). Follow up information added that the patient had developed an area of induration at the site of injection (date of onset not specified). The physician indicated that the patient did not require an office visit or other treatment. At the time of this report, the outcome of both events was unknown. Additional information has neem requested.


Changed on 5/14/2017

279670 Before After
VAERS Form:
Age:17.0
Gender:Female
Location:Texas
Vaccinated:2007-01-04
Onset:0000-00-00
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1425F / 0 UN / IM

Administered by: Private      Purchased by: Private
Symptoms: Syncope

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
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': WAES0705USA00372

Write-up:Information has been received from a physician, via a company representative, concerning a 17 year old female patient who was vaccinated IM (date unspecified), with the first dose of Gardasil. The physician reported that the patient "fainted in the office waiting room shortly after being vaccinated." The physician stated the patient was presumed to be doing fine, though she had not heard from the patient. The patient sought unspecified medical attention. 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 froma physician, concerning a 17 year old female patient, with no known drug allergies, who on 04-JAN-2007, was vaccinated IM in the lteft arm, with the first dose of GARDASIL (Lot #655165/1425F). Follow up information added that the patient had developed an area of induration at the site of injection (date of onset not specified). The physician indicated that the patient did not require an office visit or other treatment. At the time of this report, the outcome of both events was unknown. Additional information has neem requested.


Changed on 9/14/2017

279670 Before After
VAERS Form:(blank) 1
Age:17.0
Gender:Female
Location:Texas
Vaccinated:2007-01-04
Onset:0000-00-00
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1425F / 0 1 UN / IM

Administered by: Private      Purchased by: Private
Symptoms: Syncope

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
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': WAES0705USA00372

Write-up:Information has been received from a physician, via a company representative, concerning a 17 year old female patient who was vaccinated IM (date unspecified), with the first dose of Gardasil. The physician reported that the patient "fainted in the office waiting room shortly after being vaccinated." The physician stated the patient was presumed to be doing fine, though she had not heard from the patient. The patient sought unspecified medical attention. 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 froma physician, concerning a 17 year old female patient, with no known drug allergies, who on 04-JAN-2007, was vaccinated IM in the lteft arm, with the first dose of GARDASIL (Lot #655165/1425F). Follow up information added that the patient had developed an area of induration at the site of injection (date of onset not specified). The physician indicated that the patient did not require an office visit or other treatment. At the time of this report, the outcome of both events was unknown. Additional information has neem requested.


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