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This is VAERS ID 279992

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

279992
VAERS Form:
Age:17.0
Gender:Female
Location:Washington
Vaccinated:2007-05-22
Onset:2007-05-22
Submitted:2007-05-23
Entered:2007-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. M0171U / 0 LA / -

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

Write-up:Fainting episode within 5 minutes of Gardasil injection


Changed on 3/2/2010

279992 Before After
VAERS Form:
Age:17.0
Gender:Female
Location:Washington
Vaccinated:2007-05-22
Onset:2007-05-22
Submitted:2007-05-23 2007-07-06
Entered:2007-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. M0171U 655620/0171U / 0 LA / -

Administered by: Private      Purchased by: Unknown Private
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)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None Concurrent Conditions: Anxiety, Panic Attack
Preexisting Conditions: Anxiety/Panic attacks
Allergies:
Diagnostic Lab Data: None blood pressure, 05/22/07, 115/6;pulse oximetry, 05/22/07, 97 percent; total heartbeat count, 05/22/07, 68
CDC 'Split Type':

Write-up:Fainting episode within 5 minutes of Gardasil injection injection. This is in follow-up to report(s) previously submitted on 6/14/2007. Initial and follow-up information has been received from a physician concerning a 17 year old female with anxiety and panic attack who on 22-MAY-2007, at 16:30 was vaccinated, into the left deltoid , with a first dose of GARDASIL vaccine (yeast) (lot #. On 22-MAY-2007, at 16:33, the patient experienced fainting. Blood pressure was 115/60, heart rate was 68 and oxygen saturation was 97 percent. On 22-MAY-2007, within a few minutes , the patient recovered without medical intervention.. No further infoarmation is available


Changed on 9/14/2017

279992 Before After
VAERS Form:(blank) 1
Age:17.0
Gender:Female
Location:Washington
Vaccinated:2007-05-22
Onset:2007-05-22
Submitted:2007-07-06
Entered:2007-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 655620/0171U / 0 1 LA / -

Administered by: Private      Purchased by: Private
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)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Concurrent Conditions: Anxiety, Panic Attack
Preexisting Conditions: Anxiety/Panic attacks
Allergies:
Diagnostic Lab Data: blood pressure, 05/22/07, 115/6;pulse oximetry, 05/22/07, 97 percent; total heartbeat count, 05/22/07, 68
CDC 'Split Type':

Write-up:Fainting episode within 5 minutes of Gardasil injection. This is in follow-up to report(s) previously submitted on 6/14/2007. Initial and follow-up information has been received from a physician concerning a 17 year old female with anxiety and panic attack who on 22-MAY-2007, at 16:30 was vaccinated, into the left deltoid , with a first dose of GARDASIL vaccine (yeast) (lot #. On 22-MAY-2007, at 16:33, the patient experienced fainting. Blood pressure was 115/60, heart rate was 68 and oxygen saturation was 97 percent. On 22-MAY-2007, within a few minutes , the patient recovered without medical intervention.. No further infoarmation is available


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