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This is VAERS ID 282735

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

282735
VAERS Form:
Age:18.0
Gender:Female
Location:Illinois
Vaccinated:2007-06-21
Onset:2007-06-21
Submitted:2007-06-23
Entered:2007-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0012U / 0 RA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U2183AA / 0 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Hypotension, Malaise, Pallor, Syncope, Musculoskeletal stiffness

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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Patient received Gardasil. Three minutes after the vaccine was given she said: /"I don''''t feel good/" Then she went pale, stiff, fainted. She didn''''t recall what happened. She came back after 5 minutes. Her BP was low, 60/40 and received epi 0.3 mg.


Changed on 12/8/2009

282735 Before After
VAERS Form:
Age:18.0
Gender:Female
Location:Illinois
Vaccinated:2007-06-21
Onset:2007-06-21
Submitted:2007-06-23
Entered:2007-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0012U / 0 RA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U2183AA / 0 LA / IM

Administered by: Private Unknown      Purchased by: Unknown
Symptoms: Hypotension, Malaise, Pallor, Syncope, Musculoskeletal stiffness

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes No
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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Patient received Gardasil. Three minutes after the vaccine was given she said: /"I don''''t "I don''t feel good/" good" Then she went pale, stiff, fainted. She didn''''t didn''t recall what happened. She came back after 5 minutes. Her BP was low, 60/40 and received epi 0.3 mg.


Changed on 4/7/2010

282735 Before After
VAERS Form:
Age:18.0
Gender:Female
Location:Illinois
Vaccinated:2007-06-21
Onset:2007-06-21
Submitted:2007-06-23
Entered:2007-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0012U / 0 RA / IM
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2183AA / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Hypotension, Malaise, Pallor, Syncope, Musculoskeletal stiffness

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Patient received Gardasil. Three minutes after the vaccine was given she said: "I don''t feel good" Then she went pale, stiff, fainted. She didn''t recall what happened. She came back after 5 minutes. Her BP was low, 60/40 and received epi 0.3 mg.


Changed on 9/14/2017

282735 Before After
VAERS Form:(blank) 1
Age:18.0
Gender:Female
Location:Illinois
Vaccinated:2007-06-21
Onset:2007-06-21
Submitted:2007-06-23
Entered:2007-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0012U / 0 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2183AA / 0 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Hypotension, Malaise, Pallor, Syncope, Musculoskeletal stiffness

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Patient received Gardasil. Three minutes after the vaccine was given she said: "I don''t feel good" Then she went pale, stiff, fainted. She didn''t recall what happened. She came back after 5 minutes. Her BP was low, 60/40 and received epi 0.3 mg.


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