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This is VAERS ID 282175

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

282175
VAERS Form:
Age:17.0
Gender:Female
Location:Michigan
Vaccinated:2007-06-18
Onset:2007-06-18
Submitted:2007-06-18
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0249U / 0 RA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1208F / 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Loss of consciousness, Unresponsive to stimuli

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: NO
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up:Received Gardasil vaccine first, then HAV and within appx. 1 minute after vaccines client slumped to side while sitting in chair and was unresponsive for appx. 10 seconds. Staff assisted to floor and client became responsive prior to this. No injury occur"ed. Given soda to drink. Client very thin. Oatmeal for breakfast but no dinner the night before. Blood pressure laying 104/60 Pulse 76. B.P.sitting 94/60 pulse 74


Changed on 12/8/2009

282175 Before After
VAERS Form:
Age:17.0
Gender:Female
Location:Michigan
Vaccinated:2007-06-18
Onset:2007-06-18
Submitted:2007-06-18
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0249U / 0 RA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1208F / 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Loss of consciousness, Unresponsive to stimuli

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: NO
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up:Received Gardasil vaccine first, then HAV and within appx. 1 minute after vaccines client slumped to side while sitting in chair and was unresponsive for appx. 10 seconds. Staff assisted to floor and client became responsive prior to this. No injury occur"ed. occured. Given soda to drink. Client very thin. Oatmeal for breakfast but no dinner the night before. Blood pressure laying 104/60 Pulse 76. B.P.sitting 94/60 pulse 74


Changed on 9/14/2017

282175 Before After
VAERS Form:(blank) 1
Age:17.0
Gender:Female
Location:Michigan
Vaccinated:2007-06-18
Onset:2007-06-18
Submitted:2007-06-18
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0249U / 0 1 RA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1208F / 1 2 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Loss of consciousness, Unresponsive to stimuli

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: NO
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up:Received Gardasil vaccine first, then HAV and within appx. 1 minute after vaccines client slumped to side while sitting in chair and was unresponsive for appx. 10 seconds. Staff assisted to floor and client became responsive prior to this. No injury occured. Given soda to drink. Client very thin. Oatmeal for breakfast but no dinner the night before. Blood pressure laying 104/60 Pulse 76. B.P.sitting 94/60 pulse 74


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