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This is VAERS ID 283534

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

283534
VAERS Form:
Age:11.0
Gender:Female
Location:Arizona
Vaccinated:2007-06-26
Onset:2007-06-26
Submitted:2007-06-26
Entered:2007-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0960F / 2 RA / -

Administered by: Private      Purchased by: Unknown
Symptoms: Feeling abnormal, Mydriasis, Pallor, 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:
Current Illness: none
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:After receiving Gardasil at about 920am the pt stated R arm felt weird then turned pale, eyes dilated and fainted. Dr was called into the room immediately and examined pt and observed her for 45-50 min, then pt acted normal and went home.


Changed on 12/8/2009

283534 Before After
VAERS Form:
Age:11.0
Gender:Female
Location:Arizona
Vaccinated:2007-06-26
Onset:2007-06-26
Submitted:2007-06-26
Entered:2007-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0960F / 2 RA / -

Administered by: Private      Purchased by: Unknown Public
Symptoms: Feeling abnormal, Mydriasis, Pallor, 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:
Current Illness: none
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:After receiving Gardasil at about 920am the pt stated R arm felt weird then turned pale, eyes dilated and fainted. Dr was called into the room immediately and examined pt and observed her for 45-50 min, then pt acted normal and went home.


Changed on 9/14/2017

283534 Before After
VAERS Form:(blank) 1
Age:11.0
Gender:Female
Location:Arizona
Vaccinated:2007-06-26
Onset:2007-06-26
Submitted:2007-06-26
Entered:2007-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0960F / 2 3 RA / -

Administered by: Private      Purchased by: Public
Symptoms: Feeling abnormal, Mydriasis, Pallor, 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:
Current Illness: none
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:After receiving Gardasil at about 920am the pt stated R arm felt weird then turned pale, eyes dilated and fainted. Dr was called into the room immediately and examined pt and observed her for 45-50 min, then pt acted normal and went home.


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