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This is VAERS ID 282369

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 282369
VAERS Form:
Age:17.0
Gender:Female
Location:Wisconsin
Vaccinated:2007-06-11
Onset:2007-06-11
Submitted:2007-06-19
Entered:2007-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Convulsion, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Information has been received from a registered nurse concerning her 17 year old daughter with no relevant medical history reported who on 11-JUN-2007 was vaccinated intramuscularly with a 0.5 ml dose of Gardasil. There was no concomitant medication. On 1"1-JUN-2007, the patient fainted and /"exhibited seizure like behavior/" after receiving Gardasil. The patient sought unspecified medical attention. Subsequently, the patient recovered on 11-JUN-2007. Upon internal review, the patient''''s convulsion was con


Changed on 12/8/2009

VAERS ID: 282369 Before After
VAERS Form:
Age:17.0
Gender:Female
Location:Wisconsin
Vaccinated:2007-06-11
Onset:2007-06-11
Submitted:2007-06-19
Entered:2007-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Convulsion, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': (blank) WAES0706USA01961

Write-up: Information has been received from a registered nurse concerning her 17 year old daughter with no relevant medical history reported who on 11-JUN-2007 was vaccinated intramuscularly with a 0.5 ml dose of Gardasil. There was no concomitant medication. On 1"1-JUN-2007, 11-JUN-2007, the patient fainted and /"exhibited "exhibited seizure like behavior/" behavior" after receiving Gardasil. The patient sought unspecified medical attention. Subsequently, the patient recovered on 11-JUN-2007. Upon internal review, the patient''''s patient''s convulsion was con considered an other important medical event. Additional information has been requested.


Changed on 9/14/2017

VAERS ID: 282369 Before After
VAERS Form:(blank) 1
Age:17.0
Gender:Female
Location:Wisconsin
Vaccinated:2007-06-11
Onset:2007-06-11
Submitted:2007-06-19
Entered:2007-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UNK - / IM

Administered by: Other      Purchased by: Other
Symptoms: Convulsion, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0706USA01961

Write-up: Information has been received from a registered nurse concerning her 17 year old daughter with no relevant medical history reported who on 11-JUN-2007 was vaccinated intramuscularly with a 0.5 ml dose of Gardasil. There was no concomitant medication. On 11-JUN-2007, the patient fainted and "exhibited seizure like behavior" after receiving Gardasil. The patient sought unspecified medical attention. Subsequently, the patient recovered on 11-JUN-2007. Upon internal review, the patient''s convulsion was considered an other important medical event. Additional information has been requested.


Changed on 2/14/2018

VAERS ID: 282369 Before After
VAERS Form:1
Age:17.0
Gender:Female
Location:Wisconsin
Vaccinated:2007-06-11
Onset:2007-06-11
Submitted:2007-06-19
Entered:2007-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK - / IM

Administered by: Other      Purchased by: Other
Symptoms: Convulsion, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0706USA01961

Write-up: Information has been received from a registered nurse concerning her 17 year old daughter with no relevant medical history reported who on 11-JUN-2007 was vaccinated intramuscularly with a 0.5 ml dose of Gardasil. There was no concomitant medication. On 11-JUN-2007, the patient fainted and "exhibited seizure like behavior" after receiving Gardasil. The patient sought unspecified medical attention. Subsequently, the patient recovered on 11-JUN-2007. Upon internal review, the patient''s convulsion was considered an other important medical event. Additional information has been requested.


Changed on 6/14/2018

VAERS ID: 282369 Before After
VAERS Form:1
Age:17.0
Gender:Female
Location:Wisconsin
Vaccinated:2007-06-11
Onset:2007-06-11
Submitted:2007-06-19
Entered:2007-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK - / IM

Administered by: Other      Purchased by: Other
Symptoms: Convulsion, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0706USA01961

Write-up: Information has been received from a registered nurse concerning her 17 year old daughter with no relevant medical history reported who on 11-JUN-2007 was vaccinated intramuscularly with a 0.5 ml dose of Gardasil. There was no concomitant medication. On 11-JUN-2007, the patient fainted and "exhibited seizure like behavior" after receiving Gardasil. The patient sought unspecified medical attention. Subsequently, the patient recovered on 11-JUN-2007. Upon internal review, the patient''s convulsion was considered an other important medical event. Additional information has been requested.

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