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This is VAERS ID 280486

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

280486
VAERS Form:
Age:21.0
Gender:Female
Location:Tennessee
Vaccinated:2007-06-05
Onset:2007-06-05
Submitted:2007-06-05
Entered:2007-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB11BAB / 1 RA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0212U / 0 LA / IM
TD: TD ADSORBED (NO BRAND NAME) / SANOFI PASTEUR U1953AA / 1 RA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Nausea, Presyncope, Immediate post-injection reaction

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:1. (L) arm Hep A then Td 2. (L) arm Gardasil Immediate onset of nausea and pre syncopal symptoms, BP 80/60 Improved within 10 min lying down


Changed on 12/8/2009

280486 Before After
VAERS Form:
Age:21.0
Gender:Female
Location:Tennessee
Vaccinated:2007-06-05
Onset:2007-06-05
Submitted:2007-06-05
Entered:2007-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB11BAB / 1 RA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0212U / 0 LA / IM
TD: TD ADSORBED (NO BRAND NAME) / SANOFI PASTEUR U1953AA / 1 RA / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Nausea, Presyncope, Immediate post-injection reaction

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:1. (L) arm Hep A then Td 2. (L) arm Gardasil Immediate onset of nausea and pre syncopal symptoms, BP 80/60 Improved within 10 min lying down


Changed on 9/14/2017

280486 Before After
VAERS Form:(blank) 1
Age:21.0
Gender:Female
Location:Tennessee
Vaccinated:2007-06-05
Onset:2007-06-05
Submitted:2007-06-05
Entered:2007-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB11BAB / 1 2 RA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0212U / 0 1 LA / IM
TD: TD ADSORBED (NO BRAND NAME) / SANOFI PASTEUR U1953AA / 1 2 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Nausea, Presyncope, Immediate post-injection reaction

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:1. (L) arm Hep A then Td 2. (L) arm Gardasil Immediate onset of nausea and pre syncopal symptoms, BP 80/60 Improved within 10 min lying down


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=280486&WAYBACKHISTORY=ON


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