National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 282964

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 282964
VAERS Form:
Age:18.0
Gender:Female
Location:Massachusetts
Vaccinated:2007-06-18
Onset:2007-06-18
Submitted:2007-06-19
Entered:2007-06-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 05220 / 0 LA / IM
TD: TD ADSORBED (NO BRAND NAME) / SANOFI PASTEUR C2720AA / 0 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Syncope

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: on Ortho-tri-cyclen 1 tab PO QD
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Syncopal episode approx 5 min after administration


Changed on 12/8/2009

VAERS ID: 282964 Before After
VAERS Form:
Age:18.0
Gender:Female
Location:Massachusetts
Vaccinated:2007-06-18
Onset:2007-06-18
Submitted:2007-06-19
Entered:2007-06-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 05220 / 0 LA / IM
TD: TD ADSORBED (NO BRAND NAME) / SANOFI PASTEUR C2720AA / 0 LA / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Syncope

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: on Ortho-tri-cyclen 1 tab PO QD
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Syncopal episode approx 5 min after administration


Changed on 9/14/2017

VAERS ID: 282964 Before After
VAERS Form:(blank) 1
Age:18.0
Gender:Female
Location:Massachusetts
Vaccinated:2007-06-18
Onset:2007-06-18
Submitted:2007-06-19
Entered:2007-06-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 05220 / 0 1 LA / IM
TD: TD ADSORBED (NO BRAND NAME) / SANOFI PASTEUR C2720AA / 0 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Syncope

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: on Ortho-tri-cyclen 1 tab PO QD
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Syncopal episode approx 5 min after administration


Changed on 2/14/2018

VAERS ID: 282964 Before After
VAERS Form:1
Age:18.0
Gender:Female
Location:Massachusetts
Vaccinated:2007-06-18
Onset:2007-06-18
Submitted:2007-06-19
Entered:2007-06-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 05220 / 1 LA / IM
TD: TD ADSORBED (NO BRAND NAME) / SANOFI PASTEUR C2720AA / 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Syncope

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: on Ortho-tri-cyclen 1 tab PO QD
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Syncopal episode approx 5 min after administration

New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=282964&WAYBACKHISTORY=ON


Copyright © 2018 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166