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This is VAERS ID 281927

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

281927
VAERS Form:
Age:14.0
Gender:Female
Location:Ohio
Vaccinated:2007-06-08
Onset:2007-06-08
Submitted:2007-06-12
Entered:2007-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0389U / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U2278AA / 0 RA / IM

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

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: Lexapro
Current Illness: none
Preexisting Conditions: Amoxil allergy
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Passed out, vomiting


Changed on 12/8/2009

281927 Before After
VAERS Form:
Age:14.0
Gender:Female
Location:Ohio
Vaccinated:2007-06-08
Onset:2007-06-08
Submitted:2007-06-12
Entered:2007-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0389U / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U2278AA / 0 RA / IM

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

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: Lexapro
Current Illness: none
Preexisting Conditions: Amoxil allergy
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Passed out, vomiting


Changed on 4/7/2010

281927 Before After
VAERS Form:
Age:14.0
Gender:Female
Location:Ohio
Vaccinated:2007-06-08
Onset:2007-06-08
Submitted:2007-06-12
Entered:2007-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0389U / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2278AA / 0 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Loss of consciousness, Vomiting

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: Lexapro
Current Illness: none
Preexisting Conditions: Amoxil allergy
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Passed out, vomiting


Changed on 9/14/2017

281927 Before After
VAERS Form:(blank) 1
Age:14.0
Gender:Female
Location:Ohio
Vaccinated:2007-06-08
Onset:2007-06-08
Submitted:2007-06-12
Entered:2007-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0389U / 0 1 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2278AA / 0 1 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Loss of consciousness, Vomiting

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: Lexapro
Current Illness: none
Preexisting Conditions: Amoxil allergy
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Passed out, vomiting


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