National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 284168

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

284168
VAERS Form:
Age:
Gender:Female
Location:Arkansas
Vaccinated:2007-05-07
Onset:2007-05-07
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: 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)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0705USA03903

Write-up:Information has been received from a physician, via a company representative, concerning a female patient, who on approximately 07-MAY-2007 ("about 2 weeks ago"), was vaccinated IM with a dose, 0.5ml, of Gardasil. The physician reported that on 07-MAY-2007, "the patient fainted right after receiving Gardasil," and confirmed that the patient had recovered (date unspecified). The patient sought unspecified medical attention. No further information is available.


Changed on 9/14/2017

284168 Before After
VAERS Form:(blank) 1
Age:
Gender:Female
Location:Arkansas
Vaccinated:2007-05-07
Onset:2007-05-07
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UNK UN / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: 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)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0705USA03903

Write-up:Information has been received from a physician, via a company representative, concerning a female patient, who on approximately 07-MAY-2007 ("about 2 weeks ago"), was vaccinated IM with a dose, 0.5ml, of Gardasil. The physician reported that on 07-MAY-2007, "the patient fainted right after receiving Gardasil," and confirmed that the patient had recovered (date unspecified). The patient sought unspecified medical attention. No further information is available.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=284168&WAYBACKHISTORY=ON


Copyright © 2017 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166