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This is VAERS ID 281112

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

281112
VAERS Form:
Age:
Gender:Female
Location:Pennsylvania
Vaccinated:2007-05-25
Onset:2007-05-25
Submitted:2007-06-05
Entered:2007-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0244U / 0 RA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U2234AA / 0 LA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR 2644AA / 0 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Syncope, Tremor

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: None
Current Illness: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up:Had Syncopal episode lasting 5 seconds immediately following injections (3). Brief shaking associated with syncope. PMH - similar episode when treated for ingrown toenail.


Changed on 12/8/2009

281112 Before After
VAERS Form:
Age:
Gender:Female
Location:Pennsylvania
Vaccinated:2007-05-25
Onset:2007-05-25
Submitted:2007-06-05
Entered:2007-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0244U / 0 RA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U2234AA / 0 LA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR 2644AA / 0 LA / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Syncope, Tremor

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: None
Current Illness: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up:Had Syncopal episode lasting 5 seconds immediately following injections (3). Brief shaking associated with syncope. PMH - similar episode when treated for ingrown toenail.


Changed on 4/7/2010

281112 Before After
VAERS Form:
Age:
Gender:Female
Location:Pennsylvania
Vaccinated:2007-05-25
Onset:2007-05-25
Submitted:2007-06-05
Entered:2007-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0244U / 0 RA / IM
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2234AA / 0 LA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR 2644AA / 0 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Syncope, Tremor

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: None
Current Illness: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up:Had Syncopal episode lasting 5 seconds immediately following injections (3). Brief shaking associated with syncope. PMH - similar episode when treated for ingrown toenail.


Changed on 9/14/2017

281112 Before After
VAERS Form:(blank) 1
Age:
Gender:Female
Location:Pennsylvania
Vaccinated:2007-05-25
Onset:2007-05-25
Submitted:2007-06-05
Entered:2007-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0244U / 0 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2234AA / 0 1 LA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR 2644AA / 0 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Syncope, Tremor

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: None
Current Illness: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up:Had Syncopal episode lasting 5 seconds immediately following injections (3). Brief shaking associated with syncope. PMH - similar episode when treated for ingrown toenail.


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