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This is VAERS ID 282567

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 282567
Age:21.0
Gender:Female
Location:New York
Vaccinated:2007-02-15
Onset:2007-02-16
Submitted:2007-03-28
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0954F / 0 RA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2644A / 0 LA / IM

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

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Prednisone
Current Illness:
Preexisting Conditions: Autoimmune hepatitis. She did not have any illness at the time of the vaccinations.
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:A 21 year old, female patient with a history of autoimmune hepatitis, became light headed and passed out twice, about 20 hours after she received Adacel (lot number C2644AA) intramuscularly in the left deltoid and Gardasil (lot number 0954F) intramuscular"ly in the right arm, on 15 February 2007. She did not have any illness at the time of the vaccinations. She fully recovered and is stable. Follow-up information received on 26 March 2007. The patient had no illness at the time of vaccination and had recei


Changed on 12/8/2009

VAERS ID: 282567 Before After
Age:21.0
Gender:Female
Location:New York
Vaccinated:2007-02-15
Onset:2007-02-16
Submitted:2007-03-28
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0954F / 0 RA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2644A / 0 LA / IM

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

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Prednisone
Current Illness:
Preexisting Conditions: Autoimmune hepatitis. She did not have any illness at the time of the vaccinations.
Diagnostic Lab Data:
CDC 'Split Type': (blank) 200700558

Write-up:A 21 year old, female patient with a history of autoimmune hepatitis, became light headed and passed out twice, about 20 hours after she received Adacel (lot number C2644AA) intramuscularly in the left deltoid and Gardasil (lot number 0954F) intramuscular"ly intramuscularly in the right arm, on 15 February 2007. She did not have any illness at the time of the vaccinations. She fully recovered and is stable. Follow-up information received on 26 March 2007. The patient had no illness at the time of vaccination and had recei received no other vaccinations within four weeks of the 15 February 2007 immunization. The event required a doctor visit. No relevant diagnostic testing was performed.


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