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This is VAERS ID 284172

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 284172
Age:11.0
Gender:Female
Location:Oregon
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. - / - UN / UN

Administered by: Other      Purchased by: Unknown
Symptoms: Blood pressure, Loss of consciousness, Immediate post-injection reaction

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: blood pressure
CDC 'Split Type':

Write-up:Information has been received from a physician concerning an 11 year old female who was vaccinated with Gardasil. It was reported that the patient passed out ''''almost immediately/" after receiving the vaccine. No lot number was provided. The patient sough"t unspecified medical attention. The patient had her blood pressure measured. It was reported that the /"patient was fine/". Additional information has been requested.


Changed on 12/8/2009

VAERS ID: 284172 Before After
Age:11.0
Gender:Female
Location:Oregon
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. - / - UN / UN

Administered by: Other      Purchased by: Unknown
Symptoms: Blood pressure, Loss of consciousness, Immediate post-injection reaction

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: blood pressure
CDC 'Split Type': (blank) WAES0705USA03941

Write-up:Information has been received from a physician concerning an 11 year old female who was vaccinated with Gardasil. It was reported that the patient passed out ''''almost immediately/" ''almost immediately" after receiving the vaccine. No lot number was provided. The patient sough"t sought unspecified medical attention. The patient had her blood pressure measured. It was reported that the /"patient "patient was fine/". fine". Additional information has been requested.


Changed on 3/2/2010

VAERS ID: 284172 Before After
Age:11.0 12.0
Gender:Female
Location:Oregon
Vaccinated:0000-00-00 2007-04-16
Onset:0000-00-00 2007-04-16
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - 0 UN / UN

Administered by: Other Private      Purchased by: Unknown Private
Symptoms: Blood pressure, Loss of consciousness, Immediate post-injection reaction

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown None
Diagnostic Lab Data: blood pressure pressure, 04/16/07, 84/57 mmHg; blood pressure, 04/16/07, 96/54 mmHg
CDC 'Split Type': WAES0705USA03941

Write-up:Information has been received from a physician concerning an 11 year old female who was vaccinated with Gardasil. GARDASIL. It was reported that the patient passed out ''almost immediately" after receiving the vaccine. No lot number was provided. The patient sought unspecified medical attention. The patient had her blood pressure measured. It was reported that the "patient was fine". Additional information has been requested. This is in follow-up to report (s) previously submitted on 6/14/2007. In follow-up it was reported by the registered nurse concerning an 11 year old, female, with no illness a the time of the vaccination and no pre-existing allergies, birth defects, or medical conditions, who on 16-APR-2007 at 10:00 a.m., was vaccinated in the left deltoid muscle with the first dose of GARDASIL, (Lot # 657005/0314U). It was reported tht immediately after receiving the immunization the patient had a syncopal episode. The patient''s mother and the nurse caught the patient before she hit the ground. The patient was pale and diaphoratic, blood pressure was 84/57 mmHg. The patient was put in the Trendelenburg position. The patient''s blood pressure rose to 96/54 mmHg. The patient walked out after 10 minutes. It was reported that the patient recovered on 16-APR-2007. Additional information has been requested.


Changed on 6/14/2014

VAERS ID: 284172 Before After
Age:12.0
Gender:Female
Location:Oregon
Vaccinated:2007-04-16
Onset:2007-04-16
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / UN

Administered by: Private      Purchased by: Private
Symptoms: Blood pressure, Loss of consciousness, Immediate post-injection reaction

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: blood pressure, 04/16/07, 84/57 mmHg; blood pressure, 04/16/07, 96/54 mmHg
CDC 'Split Type': WAES0705USA03941

Write-up:Information has been received from a physician concerning an 11 year old female who was vaccinated with GARDASIL. It was reported that the patient passed out ''almost immediately" after receiving the vaccine. No lot number was provided. The patient sought unspecified medical attention. The patient had her blood pressure measured. It was reported that the "patient was fine". Additional information has been requested. This is in follow-up to report (s) previously submitted on 6/14/2007. In follow-up it was reported by the registered nurse concerning an 11 year old, female, with no illness a the time of the vaccination and no pre-existing allergies, birth defects, or medical conditions, who on 16-APR-2007 at 10:00 a.m., was vaccinated in the left deltoid muscle with the first dose of GARDASIL, (Lot # 657005/0314U). It was reported tht immediately after receiving the immunization the patient had a syncopal episode. The patient''s mother and the nurse caught the patient before she hit the ground. The patient was pale and diaphoratic, blood pressure was 84/57 mmHg. The patient was put in the Trendelenburg position. The patient''s blood pressure rose to 96/54 mmHg. The patient walked out after 10 minutes. It was reported that the patient recovered on 16-APR-2007. Additional information has been requested.


Changed on 5/14/2017

VAERS ID: 284172 Before After
Age:12.0
Gender:Female
Location:Oregon
Vaccinated:2007-04-16
Onset:2007-04-16
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / UN

Administered by: Private      Purchased by: Private
Symptoms: Blood pressure, Loss of consciousness, Immediate post-injection reaction

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: blood pressure, 04/16/07, 84/57 mmHg; blood pressure, 04/16/07, 96/54 mmHg
CDC 'Split Type': WAES0705USA03941

Write-up:Information has been received from a physician concerning an 11 year old female who was vaccinated with GARDASIL. It was reported that the patient passed out ''almost immediately" after receiving the vaccine. No lot number was provided. The patient sought unspecified medical attention. The patient had her blood pressure measured. It was reported that the "patient was fine". Additional information has been requested. This is in follow-up to report (s) previously submitted on 6/14/2007. In follow-up it was reported by the registered nurse concerning an 11 year old, female, with no illness a the time of the vaccination and no pre-existing allergies, birth defects, or medical conditions, who on 16-APR-2007 at 10:00 a.m., was vaccinated in the left deltoid muscle with the first dose of GARDASIL, (Lot # 657005/0314U). It was reported tht immediately after receiving the immunization the patient had a syncopal episode. The patient''s mother and the nurse caught the patient before she hit the ground. The patient was pale and diaphoratic, blood pressure was 84/57 mmHg. The patient was put in the Trendelenburg position. The patient''s blood pressure rose to 96/54 mmHg. The patient walked out after 10 minutes. It was reported that the patient recovered on 16-APR-2007. Additional information has been requested.


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