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This is VAERS ID 282901

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 282901
Age:11.0
Gender:Female
Location:Oregon
Vaccinated:2007-06-22
Onset:2007-06-22
Submitted:2007-06-25
Entered:2007-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0389U / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U2235AA / 0 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS C2610AA / 0 LA / IM

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

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: Cough x 5 days
Preexisting Conditions: none
Diagnostic Lab Data: CT of the head
CDC 'Split Type':

Write-up:Approx 5 minutes after receiving vaccines which included Tdap, HPV#1 and Menactra, pt had syncopal episode, falling to the floor and hitting her head. She was unconscious for approx 10-15 seconds, then groggy but oriented x 3. She was unable to remember"the day''''s events and kept asking the same questions repeatedly. Was observed in outpatient clinic x 2 hours with no improvement. Transported via ambulance to ER, CT of head was normal, was observed 2 more hours and discharged home.


Changed on 12/8/2009

VAERS ID: 282901 Before After
Age:11.0
Gender:Female
Location:Oregon
Vaccinated:2007-06-22
Onset:2007-06-22
Submitted:2007-06-25
Entered:2007-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0389U / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U2235AA / 0 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS C2610AA / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Computerised tomogram, Fall, Head injury, Loss of consciousness, Somnolence, Syncope

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: Cough x 5 days
Preexisting Conditions: none
Diagnostic Lab Data: CT of the head
CDC 'Split Type':

Write-up:Approx 5 minutes after receiving vaccines which included Tdap, HPV#1 and Menactra, pt had syncopal episode, falling to the floor and hitting her head. She was unconscious for approx 10-15 seconds, then groggy but oriented x 3. She was unable to remember"the day''''s remember the day''s events and kept asking the same questions repeatedly. Was observed in outpatient clinic x 2 hours with no improvement. Transported via ambulance to ER, CT of head was normal, was observed 2 more hours and discharged home.


Changed on 4/7/2010

VAERS ID: 282901 Before After
Age:11.0
Gender:Female
Location:Oregon
Vaccinated:2007-06-22
Onset:2007-06-22
Submitted:2007-06-25
Entered:2007-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0389U / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2235AA / 0 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS C2610AA / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Computerised tomogram, Fall, Head injury, Loss of consciousness, Somnolence, Syncope

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: Cough x 5 days
Preexisting Conditions: none
Diagnostic Lab Data: CT of the head
CDC 'Split Type':

Write-up:Approx 5 minutes after receiving vaccines which included Tdap, HPV#1 and Menactra, pt had syncopal episode, falling to the floor and hitting her head. She was unconscious for approx 10-15 seconds, then groggy but oriented x 3. She was unable to remember the day''s events and kept asking the same questions repeatedly. Was observed in outpatient clinic x 2 hours with no improvement. Transported via ambulance to ER, CT of head was normal, was observed 2 more hours and discharged home.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=282901&WAYBACKHISTORY=ON


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