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This is VAERS ID 282395

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

282395
VAERS Form:
Age:16.0
Gender:Female
Location:New York
Vaccinated:2007-05-17
Onset:2007-05-17
Submitted:2007-06-20
Entered:2007-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0210U / 0 LA / -

Administered by: Private      Purchased by: Unknown
Symptoms: Nausea, Syncope vasovagal, Vomiting, Immediate post-injection reaction

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: Orthrotricylen Lo
Current Illness: none
Preexisting Conditions: NKA
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Pt was given injection and immediately had a vagal reaction. Followed by nausea with vomiting 15 minutes post injection.


Changed on 9/14/2017

282395 Before After
VAERS Form:(blank) 1
Age:16.0
Gender:Female
Location:New York
Vaccinated:2007-05-17
Onset:2007-05-17
Submitted:2007-06-20
Entered:2007-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0210U / 0 1 LA / -

Administered by: Private      Purchased by: Unknown
Symptoms: Nausea, Syncope vasovagal, Vomiting, Immediate post-injection reaction

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: Orthrotricylen Lo
Current Illness: none
Preexisting Conditions: NKA
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Pt was given injection and immediately had a vagal reaction. Followed by nausea with vomiting 15 minutes post injection.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=282395&WAYBACKHISTORY=ON


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