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This is VAERS ID 280295

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 280295
VAERS Form:
Age:16.0
Gender:Female
Location:Michigan
Vaccinated:2007-06-04
Onset:2007-06-04
Submitted:2007-06-04
Entered:2007-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0389U / 0 RA / -
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U2233CA / 0 LA / -

Administered by: Private      Purchased by: Unknown
Symptoms: Loss of consciousness

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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient blacked out about 5 mins after the Gardasil was given


Changed on 12/8/2009

VAERS ID: 280295 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Michigan
Vaccinated:2007-06-04
Onset:2007-06-04
Submitted:2007-06-04
Entered:2007-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0389U / 0 RA / -
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U2233CA / 0 LA / -

Administered by: Private      Purchased by: Unknown Other
Symptoms: Loss of consciousness

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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient blacked out about 5 mins after the Gardasil was given


Changed on 4/7/2010

VAERS ID: 280295 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Michigan
Vaccinated:2007-06-04
Onset:2007-06-04
Submitted:2007-06-04
Entered:2007-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0389U / 0 RA / -
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2233CA / 0 LA / -

Administered by: Private      Purchased by: Other
Symptoms: Loss of consciousness

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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient blacked out about 5 mins after the Gardasil was given


Changed on 9/14/2017

VAERS ID: 280295 Before After
VAERS Form:(blank) 1
Age:16.0
Gender:Female
Location:Michigan
Vaccinated:2007-06-04
Onset:2007-06-04
Submitted:2007-06-04
Entered:2007-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0389U / 0 1 RA / -
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2233CA / 0 1 LA / -

Administered by: Private      Purchased by: Other
Symptoms: Loss of consciousness

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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient blacked out about 5 mins after the Gardasil was given


Changed on 2/14/2018

VAERS ID: 280295 Before After
VAERS Form:1
Age:16.0
Gender:Female
Location:Michigan
Vaccinated:2007-06-04
Onset:2007-06-04
Submitted:2007-06-04
Entered:2007-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0389U / 1 RA / -
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2233CA / 1 LA / -

Administered by: Private      Purchased by: Other
Symptoms: Loss of consciousness

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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient blacked out about 5 mins after the Gardasil was given

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