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This is VAERS ID 283777

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

283777
VAERS Form:
Age:
Gender:Female
Location:New York
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Syncope

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0705USA01309

Write-up:Initial information has been received from a physician and follow up information has been received from a nurse concerning a female patient between the ages of 11 and 19 who was vaccinated with a first dose of Gardasil. It was reported that the patient sat for a minute (after receiving the injection) and when she got up to leave she fainted in the hallway. Her outcome was not reported. The physician reported that lot numbers were not available, however, the physician will forward other information including the lot numbers. Additional information has been requested.


Changed on 3/2/2010

283777 Before After
VAERS Form:
Age:(blank) 18.0
Gender:Female
Location:New York
Vaccinated:0000-00-00 2007-03-20
Onset:0000-00-00 2007-03-20
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. - / - UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - 0185U / 0 UN / IM

Administered by: Other Private      Purchased by: Other Private
Symptoms: Syncope

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No 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: Unknown
Current Illness:
Preexisting Conditions: Unknown None
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0705USA01309

Write-up:Initial information has been received from a physician and follow up information has been received from a nurse concerning a female patient between the ages of 11 and 19 who was vaccinated with a first dose of Gardasil. It was reported that the patient sat for a minute (after receiving the injection) and when she got up to leave she fainted in the hallway. Her outcome was not reported. The physician reported that lot numbers were not available, however, the physician will forward other information including the lot numbers. Additional information has been requested. This is in follow-up to report (s) previously submitted on 6/14/2007. Follow-up information has been received from a health professional concerning the 19 year old female student with no medical history who on 20Mar-2007 at 3:15 p.m. was vaccinated IM with her first dose of GARDASIL, lot # 655618/0186U. Concomitant medication included a second dose of VAQTA (manufacturer not reported). At 3:15 p.m. the patient experienced dizziness (also reported as within 5 minutes of administration the patient experineced dizziness). The dizziness lasted approximately 5 minutes. The patient laid down on teh exam table and walked out on her own after 10 minutes. Additional infomation is not expected.


Changed on 4/7/2010

283777 Before After
VAERS Form:
Age:18.0
Gender:Female
Location:New York
Vaccinated:2007-03-20
Onset:2007-03-20
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. - / - UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0185U / 0 UN / IM

Administered by: Private      Purchased by: Private
Symptoms: Dizziness, Syncope, Immediate post-injection reaction

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: Unknown
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0705USA01309

Write-up:Initial information has been received from a physician and follow up information has been received from a nurse concerning a female patient between the ages of 11 and 19 who was vaccinated with a first dose of Gardasil. It was reported that the patient sat for a minute (after receiving the injection) and when she got up to leave she fainted in the hallway. Her outcome was not reported. The physician reported that lot numbers were not available, however, the physician will forward other information including the lot numbers. Additional information has been requested. This is in follow-up to report (s) previously submitted on 6/14/2007. Follow-up information has been received from a health professional concerning the 19 year old female student with no medical history who on 20Mar-2007 at 3:15 p.m. was vaccinated IM with her first dose of GARDASIL, lot # 655618/0186U. Concomitant medication included a second dose of VAQTA (manufacturer not reported). At 3:15 p.m. the patient experienced dizziness (also reported as within 5 minutes of administration the patient experineced dizziness). The dizziness lasted approximately 5 minutes. The patient laid down on teh exam table and walked out on her own after 10 minutes. Additional infomation is not expected.


Changed on 6/14/2014

283777 Before After
VAERS Form:
Age:18.0
Gender:Female
Location:New York
Vaccinated:2007-03-20
Onset:2007-03-20
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. - / - UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0185U / 0 UN / IM

Administered by: Private      Purchased by: Private
Symptoms: Dizziness, Syncope, Immediate post-injection reaction

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: Unknown
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0705USA01309

Write-up:Initial information has been received from a physician and follow up information has been received from a nurse concerning a female patient between the ages of 11 and 19 who was vaccinated with a first dose of Gardasil. It was reported that the patient sat for a minute (after receiving the injection) and when she got up to leave she fainted in the hallway. Her outcome was not reported. The physician reported that lot numbers were not available, however, the physician will forward other information including the lot numbers. Additional information has been requested. This is in follow-up to report (s) previously submitted on 6/14/2007. Follow-up information has been received from a health professional concerning the 19 year old female student with no medical history who on 20Mar-2007 at 3:15 p.m. was vaccinated IM with her first dose of GARDASIL, lot # 655618/0186U. Concomitant medication included a second dose of VAQTA (manufacturer not reported). At 3:15 p.m. the patient experienced dizziness (also reported as within 5 minutes of administration the patient experineced dizziness). The dizziness lasted approximately 5 minutes. The patient laid down on teh exam table and walked out on her own after 10 minutes. Additional infomation is not expected.


Changed on 5/14/2017

283777 Before After
VAERS Form:
Age:18.0
Gender:Female
Location:New York
Vaccinated:2007-03-20
Onset:2007-03-20
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. - / - UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0185U / 0 UN / IM

Administered by: Private      Purchased by: Private
Symptoms: Dizziness, Syncope, Immediate post-injection reaction

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: Unknown
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0705USA01309

Write-up:Initial information has been received from a physician and follow up information has been received from a nurse concerning a female patient between the ages of 11 and 19 who was vaccinated with a first dose of Gardasil. It was reported that the patient sat for a minute (after receiving the injection) and when she got up to leave she fainted in the hallway. Her outcome was not reported. The physician reported that lot numbers were not available, however, the physician will forward other information including the lot numbers. Additional information has been requested. This is in follow-up to report (s) previously submitted on 6/14/2007. Follow-up information has been received from a health professional concerning the 19 year old female student with no medical history who on 20Mar-2007 at 3:15 p.m. was vaccinated IM with her first dose of GARDASIL, lot # 655618/0186U. Concomitant medication included a second dose of VAQTA (manufacturer not reported). At 3:15 p.m. the patient experienced dizziness (also reported as within 5 minutes of administration the patient experineced dizziness). The dizziness lasted approximately 5 minutes. The patient laid down on teh exam table and walked out on her own after 10 minutes. Additional infomation is not expected.


Changed on 9/14/2017

283777 Before After
VAERS Form:(blank) 1
Age:18.0
Gender:Female
Location:New York
Vaccinated:2007-03-20
Onset:2007-03-20
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. - / - UNK UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0185U / 0 1 UN / IM

Administered by: Private      Purchased by: Private
Symptoms: Dizziness, Syncope, Immediate post-injection reaction

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: Unknown
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0705USA01309

Write-up:Initial information has been received from a physician and follow up information has been received from a nurse concerning a female patient between the ages of 11 and 19 who was vaccinated with a first dose of Gardasil. It was reported that the patient sat for a minute (after receiving the injection) and when she got up to leave she fainted in the hallway. Her outcome was not reported. The physician reported that lot numbers were not available, however, the physician will forward other information including the lot numbers. Additional information has been requested. This is in follow-up to report (s) previously submitted on 6/14/2007. Follow-up information has been received from a health professional concerning the 19 year old female student with no medical history who on 20Mar-2007 at 3:15 p.m. was vaccinated IM with her first dose of GARDASIL, lot # 655618/0186U. Concomitant medication included a second dose of VAQTA (manufacturer not reported). At 3:15 p.m. the patient experienced dizziness (also reported as within 5 minutes of administration the patient experineced dizziness). The dizziness lasted approximately 5 minutes. The patient laid down on teh exam table and walked out on her own after 10 minutes. Additional infomation is not expected.


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