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This is VAERS ID 282912

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 282912
Age:15.0
Gender:Female
Location:New York
Vaccinated:2007-06-16
Onset:2007-06-16
Submitted:2007-06-26
Entered:2007-06-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0523U / 1 - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Grand mal convulsion, Syncope, Oxygen supplementation

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Syncope vasovagal; Drug hypersensitivity
Preexisting Conditions:
Diagnostic Lab Data: Unknown
CDC 'Split Type':

Write-up:Information has been received from a physician and a registered nurse concerning a 15 year old female with a drug sensitivity to SEPTRA and a history of seeing a neurologist and cardiologist for neurocardio syncope (Vasovagal) who on 26-MAR-2007 was vacc"inated IM with a 0.5 ml first dose of Gardasil. On approximately, 16-JUN-2007 the patient was vaccinated IM with a 0.5 ml second dose of Gardasil (lot # 657868/0523U). There was no concomitant medications. On 16-JUN-2007, while in the physicians office, t


Changed on 12/8/2009

VAERS ID: 282912 Before After
Age:15.0
Gender:Female
Location:New York
Vaccinated:2007-06-16
Onset:2007-06-16
Submitted:2007-06-26
Entered:2007-06-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0523U / 1 - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Grand mal convulsion, Syncope, Oxygen supplementation

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Syncope vasovagal; Drug hypersensitivity
Preexisting Conditions:
Diagnostic Lab Data: Unknown
CDC 'Split Type': (blank) WAES0706USA03141

Write-up:Information has been received from a physician and a registered nurse concerning a 15 year old female with a drug sensitivity to SEPTRA and a history of seeing a neurologist and cardiologist for neurocardio syncope (Vasovagal) who on 26-MAR-2007 was vacc"inated vaccinated IM with a 0.5 ml first dose of Gardasil. On approximately, 16-JUN-2007 the patient was vaccinated IM with a 0.5 ml second dose of Gardasil (lot # 657868/0523U). There was no concomitant medications. On 16-JUN-2007, while in the physicians office, t the patient fainted and then had a grand mal seizure. The patient was given oxygen. The office called for an ambulance and the patient was taken to the emergency room and released. There were no laboratory or diagnostic test performed. On 16-JUN-2007, the patient recovered from fainting and the grand mal seizure. On 18-JUN-2007, the patient was seen in the physicians office and was referred to a neurologist. Upon internal review, grand mal seizure was considered to be an other important medical event. The registered nurse is requesting a lot check. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=282912&WAYBACKHISTORY=ON


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