National Vaccine
Information Center
Your Health. Your Family. Your Choice.

 MedAlerts Home
Search Results

This is VAERS ID 282867

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 282867
VAERS Form:
Age:18.0
Sex:Female
Location:Unknown
Vaccinated:2007-06-14
Onset:2007-06-14
Submitted:2007-06-19
Entered:2007-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0524U / - UN / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Fall, Head injury, Loss of consciousness

Life Threatening? Yes
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: healthy female
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Shortly after receiving Gardasil, pt blacked out and fell off exam table where she had been sitting. Her forehead struck the exam table stirrup, breaking it off, her left thigh scrapped against broken metal from stirrup and pt landed on the floor, where w"as found the the nurse

Changed on 12/8/2009

VAERS ID: 282867 Before After
VAERS Form:
Age:18.0
Sex:Female
Location:Unknown
Vaccinated:2007-06-14
Onset:2007-06-14
Submitted:2007-06-19
Entered:2007-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0524U / - UN / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Fall, Head injury, Loss of consciousness

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

Write-up: Shortly after receiving Gardasil, pt blacked out and fell off exam table where she had been sitting. Her forehead struck the exam table stirrup, breaking it off, her left thigh scrapped against broken metal from stirrup and pt landed on the floor, where w"as was found the the nurse

Changed on 1/5/2010

VAERS ID: 282867 Before After
VAERS Form:
Age:18.0
Sex:Female
Location:Unknown
Vaccinated:2007-06-14
Onset:2007-06-14
Submitted:2007-06-19
Entered:2007-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0524U / - UN / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Fall, Head injury, Loss of consciousness

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

Write-up: Shortly after receiving Gardasil, pt blacked out and fell off exam table where she had been sitting. Her forehead struck the exam table stirrup, breaking it off, her left thigh scrapped against broken metal from stirrup and pt landed on the floor, where was found the the nurse

Changed on 9/14/2017

VAERS ID: 282867 Before After
VAERS Form:(blank) 1
Age:18.0
Sex:Female
Location:Unknown
Vaccinated:2007-06-14
Onset:2007-06-14
Submitted:2007-06-19
Entered:2007-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0524U / - UNK UN / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Fall, Head injury, Loss of consciousness

Life Threatening? Yes
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: healthy female
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Shortly after receiving Gardasil, pt blacked out and fell off exam table where she had been sitting. Her forehead struck the exam table stirrup, breaking it off, her left thigh scrapped against broken metal from stirrup and pt landed on the floor, where was found the the nurse

Changed on 2/14/2018

VAERS ID: 282867 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:Unknown
Vaccinated:2007-06-14
Onset:2007-06-14
Submitted:2007-06-19
Entered:2007-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0524U / UNK UN / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Fall, Head injury, Loss of consciousness

Life Threatening? Yes
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: healthy female
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Shortly after receiving Gardasil, pt blacked out and fell off exam table where she had been sitting. Her forehead struck the exam table stirrup, breaking it off, her left thigh scrapped against broken metal from stirrup and pt landed on the floor, where was found the the nurse

Changed on 6/14/2018

VAERS ID: 282867 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:Unknown
Vaccinated:2007-06-14
Onset:2007-06-14
Submitted:2007-06-19
Entered:2007-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0524U / UNK UN / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Fall, Head injury, Loss of consciousness

Life Threatening? Yes
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: healthy female
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Shortly after receiving Gardasil, pt blacked out and fell off exam table where she had been sitting. Her forehead struck the exam table stirrup, breaking it off, her left thigh scrapped against broken metal from stirrup and pt landed on the floor, where was found the the nurse

Changed on 8/14/2018

VAERS ID: 282867 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:Unknown
Vaccinated:2007-06-14
Onset:2007-06-14
Submitted:2007-06-19
Entered:2007-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0524U / UNK UN / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Fall, Head injury, Loss of consciousness

Life Threatening? Yes
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: healthy female
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Shortly after receiving Gardasil, pt blacked out and fell off exam table where she had been sitting. Her forehead struck the exam table stirrup, breaking it off, her left thigh scrapped against broken metal from stirrup and pt landed on the floor, where was found the the nurse

Changed on 9/14/2018

VAERS ID: 282867 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:Unknown
Vaccinated:2007-06-14
Onset:2007-06-14
Submitted:2007-06-19
Entered:2007-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0524U / UNK UN / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Fall, Head injury, Loss of consciousness

Life Threatening? Yes
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: healthy female
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Shortly after receiving Gardasil, pt blacked out and fell off exam table where she had been sitting. Her forehead struck the exam table stirrup, breaking it off, her left thigh scrapped against broken metal from stirrup and pt landed on the floor, where was found the the nurse

Changed on 10/14/2018

VAERS ID: 282867 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:Unknown
Vaccinated:2007-06-14
Onset:2007-06-14
Submitted:2007-06-19
Entered:2007-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0524U / UNK UN / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Fall, Head injury, Loss of consciousness

Life Threatening? Yes
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: healthy female
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Shortly after receiving Gardasil, pt blacked out and fell off exam table where she had been sitting. Her forehead struck the exam table stirrup, breaking it off, her left thigh scrapped against broken metal from stirrup and pt landed on the floor, where was found the the nurse

Changed on 12/10/2020

VAERS ID: 282867 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:Unknown New York
Vaccinated:2007-06-14
Onset:2007-06-14
Submitted:2007-06-19
Entered:2007-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0524U / UNK UN / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Fall, Head injury, Loss of consciousness

Life Threatening? Yes
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: healthy female
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Shortly after receiving Gardasil, pt blacked out and fell off exam table where she had been sitting. Her forehead struck the exam table stirrup, breaking it off, her left thigh scrapped against broken metal from stirrup and pt landed on the floor, where was found the the nurse

Changed on 12/24/2020

VAERS ID: 282867 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:New York
Vaccinated:2007-06-14
Onset:2007-06-14
Submitted:2007-06-19
Entered:2007-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0524U / UNK UN / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Fall, Head injury, Loss of consciousness

Life Threatening? Yes
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: healthy female
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Shortly after receiving Gardasil, pt blacked out and fell off exam table where she had been sitting. Her forehead struck the exam table stirrup, breaking it off, her left thigh scrapped against broken metal from stirrup and pt landed on the floor, where was found the the nurse

Changed on 12/30/2020

VAERS ID: 282867 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:New York
Vaccinated:2007-06-14
Onset:2007-06-14
Submitted:2007-06-19
Entered:2007-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0524U / UNK UN / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Fall, Head injury, Loss of consciousness

Life Threatening? Yes
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: healthy female
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Shortly after receiving Gardasil, pt blacked out and fell off exam table where she had been sitting. Her forehead struck the exam table stirrup, breaking it off, her left thigh scrapped against broken metal from stirrup and pt landed on the floor, where was found the the nurse

New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=282867&WAYBACKHISTORY=ON


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166