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This is VAERS ID 281699

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

281699
VAERS Form:
Age:
Gender:Female
Location:Arizona
Vaccinated:2007-06-14
Onset:2007-06-14
Submitted:2007-06-14
Entered:2007-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB149AA / 0 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 0 RA / IM

Administered by: Military      Purchased by: Unknown
Symptoms: Cold sweat, Convulsion, Hypotonia, Loss of consciousness, Pallor

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

Write-up:Pt was given two shots and immediately after administered patient became pale, limp and clammy. Patient passed out and began to have seizure activity for a few seconds. Pt regained consciousness and her vital signs were taken and were within normal range.


Changed on 12/8/2009

281699 Before After
VAERS Form:
Age:
Gender:Female
Location:Arizona
Vaccinated:2007-06-14
Onset:2007-06-14
Submitted:2007-06-14
Entered:2007-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB149AA / 0 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 0 RA / IM

Administered by: Military      Purchased by: Unknown Military
Symptoms: Cold sweat, Convulsion, Hypotonia, Loss of consciousness, Pallor

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

Write-up:Pt was given two shots and immediately after administered patient became pale, limp and clammy. Patient passed out and began to have seizure activity for a few seconds. Pt regained consciousness and her vital signs were taken and were within normal range.


Changed on 9/14/2017

281699 Before After
VAERS Form:(blank) 1
Age:
Gender:Female
Location:Arizona
Vaccinated:2007-06-14
Onset:2007-06-14
Submitted:2007-06-14
Entered:2007-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB149AA / 0 1 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 0 1 RA / IM

Administered by: Military      Purchased by: Military
Symptoms: Cold sweat, Convulsion, Hypotonia, Loss of consciousness, Pallor

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

Write-up:Pt was given two shots and immediately after administered patient became pale, limp and clammy. Patient passed out and began to have seizure activity for a few seconds. Pt regained consciousness and her vital signs were taken and were within normal range.


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Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=281699&WAYBACKHISTORY=ON


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