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This is VAERS ID 283521

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 283521
VAERS Form:
Age:12.0
Gender:Female
Location:Maine
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-06-29
Entered:2007-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / UN

Administered by: Other      Purchased by: Unknown
Symptoms: Blindness transient, Dizziness, Mydriasis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type':

Write-up: Information has been received from a physician, via a company representative, concerning a 12 year old female patient, who was vaccinated (date not specified) with the first dose of Gardasil, and following vaccination, felt like she was going to faint. Th"e physician confirmed that the patient did not actually faint, though she had dilated pupils and she /"lost sight/" for approximately 10 minutes. The patient was instructed to lie down for 10 minutes, and then reported /"she was okay./" Upon internal revi


Changed on 12/8/2009

VAERS ID: 283521 Before After
VAERS Form:
Age:12.0
Gender:Female
Location:Maine
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-06-29
Entered:2007-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / UN

Administered by: Other      Purchased by: Unknown Other
Symptoms: Blindness transient, Dizziness, Mydriasis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': (blank) WAES0706USA04134

Write-up: Information has been received from a physician, via a company representative, concerning a 12 year old female patient, who was vaccinated (date not specified) with the first dose of Gardasil, and following vaccination, felt like she was going to faint. Th"e The physician confirmed that the patient did not actually faint, though she had dilated pupils and she /"lost sight/" "lost sight" for approximately 10 minutes. The patient was instructed to lie down for 10 minutes, and then reported /"she "she was okay./" okay." Upon internal revi review, "lost sight for approximately 10 minutes," was determined to be serious as an other important medical event. Additional information has been requested.


Changed on 9/14/2017

VAERS ID: 283521 Before After
VAERS Form:(blank) 1
Age:12.0
Gender:Female
Location:Maine
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-06-29
Entered:2007-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Blindness transient, Dizziness, Mydriasis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0706USA04134

Write-up: Information has been received from a physician, via a company representative, concerning a 12 year old female patient, who was vaccinated (date not specified) with the first dose of Gardasil, and following vaccination, felt like she was going to faint. The physician confirmed that the patient did not actually faint, though she had dilated pupils and she "lost sight" for approximately 10 minutes. The patient was instructed to lie down for 10 minutes, and then reported "she was okay." Upon internal review, "lost sight for approximately 10 minutes," was determined to be serious as an other important medical event. Additional information has been requested.


Changed on 2/14/2018

VAERS ID: 283521 Before After
VAERS Form:1
Age:12.0
Gender:Female
Location:Maine
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-06-29
Entered:2007-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Blindness transient, Dizziness, Mydriasis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0706USA04134

Write-up: Information has been received from a physician, via a company representative, concerning a 12 year old female patient, who was vaccinated (date not specified) with the first dose of Gardasil, and following vaccination, felt like she was going to faint. The physician confirmed that the patient did not actually faint, though she had dilated pupils and she "lost sight" for approximately 10 minutes. The patient was instructed to lie down for 10 minutes, and then reported "she was okay." Upon internal review, "lost sight for approximately 10 minutes," was determined to be serious as an other important medical event. Additional information has been requested.


Changed on 6/14/2018

VAERS ID: 283521 Before After
VAERS Form:1
Age:12.0
Gender:Female
Location:Maine
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-06-29
Entered:2007-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Blindness transient, Dizziness, Mydriasis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0706USA04134

Write-up: Information has been received from a physician, via a company representative, concerning a 12 year old female patient, who was vaccinated (date not specified) with the first dose of Gardasil, and following vaccination, felt like she was going to faint. The physician confirmed that the patient did not actually faint, though she had dilated pupils and she "lost sight" for approximately 10 minutes. The patient was instructed to lie down for 10 minutes, and then reported "she was okay." Upon internal review, "lost sight for approximately 10 minutes," was determined to be serious as an other important medical event. Additional information has been requested.

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