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This is VAERS ID 284205

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

284205
VAERS Form:
Age:14.0
Gender:Female
Location:North Carolina
Vaccinated:2007-07-09
Onset:2007-07-09
Submitted:2007-07-09
Entered:2007-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0181U / 1 LA / UN

Administered by: Private      Purchased by: Unknown
Symptoms: Syncope, Tremor, Unresponsive to stimuli

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

Write-up:Within 5 sec after giving shot, child started shaking, unresponsive for 15-30 sec then fainted.


Changed on 12/8/2009

284205 Before After
VAERS Form:
Age:14.0
Gender:Female
Location:North Carolina
Vaccinated:2007-07-09
Onset:2007-07-09
Submitted:2007-07-09
Entered:2007-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0181U / 1 LA / UN

Administered by: Private      Purchased by: Unknown Private
Symptoms: Syncope, Tremor, Unresponsive to stimuli

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': (blank) NC07075

Write-up:Within 5 sec after giving shot, child started shaking, unresponsive for 15-30 sec then fainted.


Changed on 9/14/2017

284205 Before After
VAERS Form:(blank) 1
Age:14.0
Gender:Female
Location:North Carolina
Vaccinated:2007-07-09
Onset:2007-07-09
Submitted:2007-07-09
Entered:2007-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0181U / 1 2 LA / UN

Administered by: Private      Purchased by: Private
Symptoms: Syncope, Tremor, Unresponsive to stimuli

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': NC07075

Write-up:Within 5 sec after giving shot, child started shaking, unresponsive for 15-30 sec then fainted.


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