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This is VAERS ID 284237

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 284237
Age:16.0
Gender:Female
Location:Pennsylvania
Vaccinated:2007-07-10
Onset:2007-07-10
Submitted:2007-07-10
Entered:2007-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0387U / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U2365AA / 2 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B018AD / 0 RA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion, Fall, Injury, Syncope vasovagal

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Pt. had a vasovagal response to Gardasil vaccine in the office, falling onto the floor and hitting her face. Pt had seizure activity, per her mother. Pt was moved to a chair, was sitting and talking and went on to have further seizure acitivty and 911 was"called. we monitered the pt. until medics arrived and she was transported to the ED.


Changed on 12/8/2009

VAERS ID: 284237 Before After
Age:16.0
Gender:Female
Location:Pennsylvania
Vaccinated:2007-07-10
Onset:2007-07-10
Submitted:2007-07-10
Entered:2007-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0387U / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U2365AA / 2 0 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B018AD / 0 RA / IM

Administered by: Private Unknown      Purchased by: Unknown
Symptoms: Convulsion, Fall, Injury, Syncope vasovagal

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Pt. had a vasovagal response to Gardasil vaccine in the office, falling onto the floor and hitting her face. Pt had seizure activity, per her mother. Pt was moved to a chair, was sitting and talking and went on to have further seizure acitivty and 911 was"called. was called. we monitered the pt. until medics arrived and she was transported to the ED.


Changed on 4/7/2010

VAERS ID: 284237 Before After
Age:16.0
Gender:Female
Location:Pennsylvania
Vaccinated:2007-07-10
Onset:2007-07-10
Submitted:2007-07-10
Entered:2007-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0387U / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2365AA / 0 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B018AD / 0 RA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Convulsion, Fall, Injury, Syncope vasovagal

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Pt. had a vasovagal response to Gardasil vaccine in the office, falling onto the floor and hitting her face. Pt had seizure activity, per her mother. Pt was moved to a chair, was sitting and talking and went on to have further seizure acitivty and 911 was called. we monitered the pt. until medics arrived and she was transported to the ED.


Changed on 6/14/2014

VAERS ID: 284237 Before After
Age:16.0
Gender:Female
Location:Pennsylvania
Vaccinated:2007-07-10
Onset:2007-07-10
Submitted:2007-07-10
Entered:2007-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0387U / 0 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2365AA / 0 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B018AD / 0 RA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Convulsion, Fall, Injury, Syncope vasovagal

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Pt. had a vasovagal response to Gardasil vaccine in the office, falling onto the floor and hitting her face. Pt had seizure activity, per her mother. Pt was moved to a chair, was sitting and talking and went on to have further seizure acitivty and 911 was called. we monitered the pt. until medics arrived and she was transported to the ED.


Changed on 5/14/2017

VAERS ID: 284237 Before After
Age:16.0
Gender:Female
Location:Pennsylvania
Vaccinated:2007-07-10
Onset:2007-07-10
Submitted:2007-07-10
Entered:2007-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0387U / 0 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2365AA / 0 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B018AD / 0 RA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Convulsion, Fall, Injury, Syncope vasovagal

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Pt. had a vasovagal response to Gardasil vaccine in the office, falling onto the floor and hitting her face. Pt had seizure activity, per her mother. Pt was moved to a chair, was sitting and talking and went on to have further seizure acitivty and 911 was called. we monitered the pt. until medics arrived and she was transported to the ED.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=284237&WAYBACKHISTORY=ON


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