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This is VAERS ID 279893

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 279893
Age:14.0
Gender:Female
Location:Kentucky
Vaccinated:2007-05-14
Onset:2007-05-14
Submitted:2007-05-25
Entered:2007-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0388U / 2 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Blood pressure decreased, Dyskinesia, Heart rate decreased, Heart rate increased, Hypotension

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: blood pressure 05/14/07 72/48 mmHg, total heartbeat count 05/14/07 38bpm
CDC 'Split Type':

Write-up:Information has been received from a health professional, concerning a 14 year old female student, with no known drug allergies, who on 14-MAY-2007, at 3:00pm, was vaccinated IM in the left arm, with the third dose of Gardasil (Lot #657622/0388U). There w"as no illness at the time of vaccination. The reporter indicated that immediately after vaccination, at 3:00pm, on 14-MAY-2007 the patient /"passed out and started jerking all over the shot was given/" (duration of symptoms and treatment were not reported


Changed on 12/8/2009

VAERS ID: 279893 Before After
Age:14.0
Gender:Female
Location:Kentucky
Vaccinated:2007-05-14
Onset:2007-05-14
Submitted:2007-05-25
Entered:2007-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0388U / 2 LA / IM

Administered by: Private      Purchased by: Unknown Other
Symptoms: Blood pressure decreased, Dyskinesia, Heart rate decreased, Heart rate increased, Hypotension, Loss of consciousness, Immediate post-injection reaction

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: blood pressure 05/14/07 72/48 mmHg, total heartbeat count 05/14/07 38bpm
CDC 'Split Type': (blank) WAES0705USA04237

Write-up:Information has been received from a health professional, concerning a 14 year old female student, with no known drug allergies, who on 14-MAY-2007, at 3:00pm, was vaccinated IM in the left arm, with the third dose of Gardasil (Lot #657622/0388U). There w"as was no illness at the time of vaccination. The reporter indicated that immediately after vaccination, at 3:00pm, on 14-MAY-2007 the patient /"passed "passed out and started jerking all over the shot was given/" given" (duration of symptoms and treatment were not reported reported). The patient''s vital signs included a blood pressure of 72/48mmHg, and a pulse of 38bpm. The reporter confirmed that the patient recovered on the same day, 14-MAY-2007. The reporter stated that the events of passed out, jerking all over, pulse very low and blood pressure very low, required medical intervention to prevent serious criteria, and were considered as an other important medical event. Additional information has been requested.


Changed on 6/14/2014

VAERS ID: 279893 Before After
Age:14.0
Gender:Female
Location:Kentucky
Vaccinated:2007-05-14
Onset:2007-05-14
Submitted:2007-05-25
Entered:2007-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0388U / 2 LA / IM

Administered by: Private      Purchased by: Other
Symptoms: Blood pressure decreased, Dyskinesia, Heart rate decreased, Heart rate increased, Hypotension, Loss of consciousness, Immediate post-injection reaction

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: blood pressure 05/14/07 72/48 mmHg, total heartbeat count 05/14/07 38bpm
CDC 'Split Type': WAES0705USA04237

Write-up:Information has been received from a health professional, concerning a 14 year old female student, with no known drug allergies, who on 14-MAY-2007, at 3:00pm, was vaccinated IM in the left arm, with the third dose of Gardasil (Lot #657622/0388U). There was no illness at the time of vaccination. The reporter indicated that immediately after vaccination, at 3:00pm, on 14-MAY-2007 the patient "passed out and started jerking all over the shot was given" (duration of symptoms and treatment were not reported). The patient''s vital signs included a blood pressure of 72/48mmHg, and a pulse of 38bpm. The reporter confirmed that the patient recovered on the same day, 14-MAY-2007. The reporter stated that the events of passed out, jerking all over, pulse very low and blood pressure very low, required medical intervention to prevent serious criteria, and were considered as an other important medical event. Additional information has been requested.


Changed on 3/14/2015

VAERS ID: 279893 Before After
Age:14.0
Gender:Female
Location:Kentucky
Vaccinated:2007-05-14
Onset:2007-05-14
Submitted:2007-05-25
Entered:2007-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0388U / 2 LA / IM

Administered by: Private      Purchased by: Other
Symptoms: Blood pressure decreased, Dyskinesia, Heart rate decreased, Heart rate increased, Hypotension, Loss of consciousness, Immediate post-injection reaction

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: blood pressure 05/14/07 72/48 mmHg, total heartbeat count 05/14/07 38bpm
CDC 'Split Type': WAES0705USA04237

Write-up:Information has been received from a health professional, concerning a 14 year old female student, with no known drug allergies, who on 14-MAY-2007, at 3:00pm, was vaccinated IM in the left arm, with the third dose of Gardasil (Lot #657622/0388U). There was no illness at the time of vaccination. The reporter indicated that immediately after vaccination, at 3:00pm, on 14-MAY-2007 the patient "passed out and started jerking all over the shot was given" (duration of symptoms and treatment were not reported). The patient''s vital signs included a blood pressure of 72/48mmHg, and a pulse of 38bpm. The reporter confirmed that the patient recovered on the same day, 14-MAY-2007. The reporter stated that the events of passed out, jerking all over, pulse very low and blood pressure very low, required medical intervention to prevent serious criteria, and were considered as an other important medical event. Additional information has been requested.


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