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This is VAERS ID 280449

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

280449
VAERS Form:
Age:16.0
Gender:Female
Location:Unknown
Vaccinated:2007-05-29
Onset:2007-05-29
Submitted:2007-06-04
Entered:2007-06-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0246U / 1 RA / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0522U / - LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U2277AA / - RA / UN
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0455U / 1 LA / UN

Administered by: Private      Purchased by: Unknown
Symptoms: Blood pressure decreased, Syncope

Life Threatening? Yes
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: none
Allergies:
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up:After few moments of receiving multiple vax and Gardasil, patient had a syncope, blood pressure dropped. She recovered. 06/06/07-records received. Vaccine record documents on 5/30/07 Gardasil lot# 0522U, Varicella Lot #0455U, Menactra lot#U2277AA, Hepatit"is A 2 lot#0246U. After vaccination patien left room and had loss of consciousness for 10 seconds. BP 88/54. Felt better after resting. Walked out of office with mother


Changed on 12/8/2009

280449 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Unknown
Vaccinated:2007-05-29
Onset:2007-05-29
Submitted:2007-06-04
Entered:2007-06-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0246U / 1 RA / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0522U / - LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U2277AA / - RA / UN
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0455U / 1 LA / UN

Administered by: Private      Purchased by: Unknown
Symptoms: Blood pressure decreased, Syncope

Life Threatening? Yes
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: none
Allergies:
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up:After few moments of receiving multiple vax and Gardasil, patient had a syncope, blood pressure dropped. She recovered. 06/06/07-records received. Vaccine record documents on 5/30/07 Gardasil lot# 0522U, Varicella Lot #0455U, Menactra lot#U2277AA, Hepatit"is Hepatitis A 2 lot#0246U. After vaccination patien left room and had loss of consciousness for 10 seconds. BP 88/54. Felt better after resting. Walked out of office with mother


Changed on 4/7/2010

280449 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Unknown
Vaccinated:2007-05-29
Onset:2007-05-29
Submitted:2007-06-04
Entered:2007-06-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0246U / 1 RA / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0522U / - LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2277AA / - RA / UN
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0455U / 1 LA / UN

Administered by: Private      Purchased by: Unknown
Symptoms: Blood pressure decreased, Syncope

Life Threatening? Yes
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: none
Allergies:
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up:After few moments of receiving multiple vax and Gardasil, patient had a syncope, blood pressure dropped. She recovered. 06/06/07-records received. Vaccine record documents on 5/30/07 Gardasil lot# 0522U, Varicella Lot #0455U, Menactra lot#U2277AA, Hepatitis A 2 lot#0246U. After vaccination patien left room and had loss of consciousness for 10 seconds. BP 88/54. Felt better after resting. Walked out of office with mother


Changed on 9/14/2017

280449 Before After
VAERS Form:(blank) 1
Age:16.0
Gender:Female
Location:Unknown
Vaccinated:2007-05-29
Onset:2007-05-29
Submitted:2007-06-04
Entered:2007-06-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0246U / 1 2 RA / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0522U / - UNK LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2277AA / - UNK RA / UN
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0455U / 1 2 LA / UN

Administered by: Private      Purchased by: Unknown
Symptoms: Blood pressure decreased, Syncope

Life Threatening? Yes
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: none
Allergies:
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up:After few moments of receiving multiple vax and Gardasil, patient had a syncope, blood pressure dropped. She recovered. 06/06/07-records received. Vaccine record documents on 5/30/07 Gardasil lot# 0522U, Varicella Lot #0455U, Menactra lot#U2277AA, Hepatitis A 2 lot#0246U. After vaccination patien left room and had loss of consciousness for 10 seconds. BP 88/54. Felt better after resting. Walked out of office with mother


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