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This is VAERS ID 283757

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

283757
VAERS Form:
Age:17.0
Gender:Female
Location:Unknown
Vaccinated:2007-04-17
Onset:2007-04-17
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0962F / - UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Dizziness, Injection site pain

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: [therapy unspecified]; MENACTRA
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0705USA00858

Write-up:Information has been received from a physician via a company representative concerning a 17 year old female patient with an unremarkable medical history and no known drug reactions/allergies who on 17-APR-2007 was vaccinated with Gardasil (Lot #654510/0962F). Concomitant therapy included Menactra and "T-DEP vaccines". On 17-APR-2007 the patient experienced pain at injection site and felt faint right after receiving this initial dose. The patient felt fine upon observation by the health care provider about 20 minutes after receiving the injection. It was noted the patient received her vaccine injection on an empty stomach. Subsequently, the patient recovered from pain at injection site and felt faint right after receiving initial dose. It was also noted the patient will receive future doses of Gardasil. No further information is available.


Changed on 9/14/2017

283757 Before After
VAERS Form:(blank) 1
Age:17.0
Gender:Female
Location:Unknown
Vaccinated:2007-04-17
Onset:2007-04-17
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0962F / - UNK UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Dizziness, Injection site pain

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: [therapy unspecified]; MENACTRA
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0705USA00858

Write-up:Information has been received from a physician via a company representative concerning a 17 year old female patient with an unremarkable medical history and no known drug reactions/allergies who on 17-APR-2007 was vaccinated with Gardasil (Lot #654510/0962F). Concomitant therapy included Menactra and "T-DEP vaccines". On 17-APR-2007 the patient experienced pain at injection site and felt faint right after receiving this initial dose. The patient felt fine upon observation by the health care provider about 20 minutes after receiving the injection. It was noted the patient received her vaccine injection on an empty stomach. Subsequently, the patient recovered from pain at injection site and felt faint right after receiving initial dose. It was also noted the patient will receive future doses of Gardasil. No further information is available.


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