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This is VAERS ID 282216

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

282216
VAERS Form:
Age:18.0
Gender:Female
Location:Pennsylvania
Vaccinated:2007-06-04
Onset:2007-06-04
Submitted:2007-06-18
Entered:2007-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / UN
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR - / - UN / UN

Administered by: Other      Purchased by: Unknown
Symptoms: Grand mal convulsion, Loss of consciousness, Syncope

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: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up:Information has been received from a physician concerning an 18 year old female with no pertinent medical history who on 04-JUN-2007 received her first dose of Gardasil concomitantly with a dose of Menactra. After administration of the Gardasil on 04-JUN-"2007, the patient fainted, was unconscious for 45-60 seconds and exhibited tonic-clonic seizure-like activity. There were no laboratory tests performed. She sought unspecified medical attention. No treatment was required. The patient left the office fully


Changed on 12/8/2009

282216 Before After
VAERS Form:
Age:18.0
Gender:Female
Location:Pennsylvania
Vaccinated:2007-06-04
Onset:2007-06-04
Submitted:2007-06-18
Entered:2007-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / UN
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR - / - UN / UN

Administered by: Other      Purchased by: Unknown Other
Symptoms: Grand mal convulsion, Loss of consciousness, Syncope

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: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': (blank) WAES0706USA01993

Write-up:Information has been received from a physician concerning an 18 year old female with no pertinent medical history who on 04-JUN-2007 received her first dose of Gardasil concomitantly with a dose of Menactra. After administration of the Gardasil on 04-JUN-"2007, 04-JUN-2007, the patient fainted, was unconscious for 45-60 seconds and exhibited tonic-clonic seizure-like activity. There were no laboratory tests performed. She sought unspecified medical attention. No treatment was required. The patient left the office fully recovered. Upon internal review, tonic-clonic seizure-like activity was considered to be an other important medical event. Additional information has been requested.


Changed on 4/7/2010

282216 Before After
VAERS Form:
Age:18.0
Gender:Female
Location:Pennsylvania
Vaccinated:2007-06-04
Onset:2007-06-04
Submitted:2007-06-18
Entered:2007-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / UN
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR - / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Grand mal convulsion, Loss of consciousness, Syncope

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: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0706USA01993

Write-up:Information has been received from a physician concerning an 18 year old female with no pertinent medical history who on 04-JUN-2007 received her first dose of Gardasil concomitantly with a dose of Menactra. After administration of the Gardasil on 04-JUN-2007, the patient fainted, was unconscious for 45-60 seconds and exhibited tonic-clonic seizure-like activity. There were no laboratory tests performed. She sought unspecified medical attention. No treatment was required. The patient left the office fully recovered. Upon internal review, tonic-clonic seizure-like activity was considered to be an other important medical event. Additional information has been requested.


Changed on 9/14/2017

282216 Before After
VAERS Form:(blank) 1
Age:18.0
Gender:Female
Location:Pennsylvania
Vaccinated:2007-06-04
Onset:2007-06-04
Submitted:2007-06-18
Entered:2007-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 1 UN / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR - / - UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Grand mal convulsion, Loss of consciousness, Syncope

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: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0706USA01993

Write-up:Information has been received from a physician concerning an 18 year old female with no pertinent medical history who on 04-JUN-2007 received her first dose of Gardasil concomitantly with a dose of Menactra. After administration of the Gardasil on 04-JUN-2007, the patient fainted, was unconscious for 45-60 seconds and exhibited tonic-clonic seizure-like activity. There were no laboratory tests performed. She sought unspecified medical attention. No treatment was required. The patient left the office fully recovered. Upon internal review, tonic-clonic seizure-like activity was considered to be an other important medical event. Additional information has been requested.


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