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This is VAERS ID 283930

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

283930
VAERS Form:
Age:24.0
Gender:Female
Location:New Jersey
Vaccinated:2007-04-23
Onset:2007-04-23
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 0 UN / IM

Administered by: Private      Purchased by: Private
Symptoms: Blood pressure, 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Blood pressure 04/23/07 130/70
CDC 'Split Type': WAES0705USA02126

Write-up:Information has been received from a registered nurse concerning a 24 year old white female teacher (weight 133#, height 62") who on 23-APR-2007 was vaccinated with the first dose of Gardasil (lot #657617/0384U), IM in the deltoid. Concomitant medication was not reported. On 23-APR-2007 approximately 5 minutes after vaccine was administered, the patient fainted. The patient was treated with a cold pack to her head and she was instructed to lie down. The patient''s blood pressure was 130/70. Subsequently that same day, the patient recovered from fainting and left the physicians office unassisted. Additional information has been requested.


Changed on 3/2/2010

283930 Before After
VAERS Form:
Age:24.0
Gender:Female
Location:New Jersey
Vaccinated:2007-04-23
Onset:2007-04-23
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 0 UN AR / IM

Administered by: Private      Purchased by: Private
Symptoms: Blood pressure, 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Blood pressure 04/23/07 130/70 130/70.
CDC 'Split Type': WAES0705USA02126

Write-up:This is in follow-up to report (s) previously submitted on 6/14/2007. Information has been received from a registered nurse concerning a 24 year old white female teacher (weight 133#, height 62") who on 23-APR-2007 was vaccinated with the first dose (also reported as the second dose) of Gardasil GARDASIL (lot #657617/0384U), IM in the deltoid. Concomitant medication was not reported. On 23-APR-2007 approximately 5 minutes after vaccine was administered, the patient fainted. The patient was treated with a cold pack to her head and she was instructed to lie down. The patient''s blood pressure was 130/70. Subsequently that same day, the patient recovered from fainting and left the physicians office unassisted. Additional information has been requested.


Changed on 6/14/2014

283930 Before After
VAERS Form:
Age:24.0
Gender:Female
Location:New Jersey
Vaccinated:2007-04-23
Onset:2007-04-23
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 0 AR / IM

Administered by: Private      Purchased by: Private
Symptoms: Blood pressure, 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Blood pressure 04/23/07 130/70.
CDC 'Split Type': WAES0705USA02126

Write-up:This is in follow-up to report (s) previously submitted on 6/14/2007. Information has been received from a registered nurse concerning a 24 year old female teacher (weight 133#, height 62") who on 23-APR-2007 was vaccinated with the first dose (also reported as the second dose) of GARDASIL (lot #657617/0384U), IM in the deltoid. Concomitant medication was not reported. On 23-APR-2007 approximately 5 minutes after vaccine was administered, the patient fainted. The patient was treated with a cold pack to her head and she was instructed to lie down. The patient''s blood pressure was 130/70. Subsequently that same day, the patient recovered from fainting and left the physicians office unassisted. Additional information has been requested.


Changed on 5/14/2017

283930 Before After
VAERS Form:
Age:24.0
Gender:Female
Location:New Jersey
Vaccinated:2007-04-23
Onset:2007-04-23
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 0 AR / IM

Administered by: Private      Purchased by: Private
Symptoms: Blood pressure, 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Blood pressure 04/23/07 130/70.
CDC 'Split Type': WAES0705USA02126

Write-up:This is in follow-up to report (s) previously submitted on 6/14/2007. Information has been received from a registered nurse concerning a 24 year old female teacher (weight 133#, height 62") who on 23-APR-2007 was vaccinated with the first dose (also reported as the second dose) of GARDASIL (lot #657617/0384U), IM in the deltoid. Concomitant medication was not reported. On 23-APR-2007 approximately 5 minutes after vaccine was administered, the patient fainted. The patient was treated with a cold pack to her head and she was instructed to lie down. The patient''s blood pressure was 130/70. Subsequently that same day, the patient recovered from fainting and left the physicians office unassisted. Additional information has been requested.


Changed on 9/14/2017

283930 Before After
VAERS Form:(blank) 1
Age:24.0
Gender:Female
Location:New Jersey
Vaccinated:2007-04-23
Onset:2007-04-23
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 0 1 AR / IM

Administered by: Private      Purchased by: Private
Symptoms: Blood pressure, 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Blood pressure 04/23/07 130/70.
CDC 'Split Type': WAES0705USA02126

Write-up:This is in follow-up to report (s) previously submitted on 6/14/2007. Information has been received from a registered nurse concerning a 24 year old female teacher (weight 133#, height 62") who on 23-APR-2007 was vaccinated with the first dose (also reported as the second dose) of GARDASIL (lot #657617/0384U), IM in the deltoid. Concomitant medication was not reported. On 23-APR-2007 approximately 5 minutes after vaccine was administered, the patient fainted. The patient was treated with a cold pack to her head and she was instructed to lie down. The patient''s blood pressure was 130/70. Subsequently that same day, the patient recovered from fainting and left the physicians office unassisted. Additional information has been requested.


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