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This is VAERS ID 284261

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 284261
Age:17.0
Gender:Female
Location:California
Vaccinated:2007-01-02
Onset:2007-01-02
Submitted:2007-07-10
Entered:2007-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB129AA / 0 UN / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637F / 0 UN / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B014AA / 0 UN / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Loss of consciousness, Nuclear magnetic resonance imaging brain normal, Visual disturbance

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Allegra-D, Flonase, Ortho Tricyclen
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: MRI of brain was negative. Labs ordered but were not done.
CDC 'Split Type':

Write-up:On 4/11/2007, patient reported to me that after her 1st Gardisil vaccine on 01/02/2007, she had a /"blackout/" feeling as she was leaving the office. This occurred again after the 2nd Gardisil vaccine was given on 3/28/2007.She stated that /"everything w"ent black/" and she could not see. She was very much alert and could hear, at that time. This episode lasted approximately 1 minute. These episodes have happened recurrently since that time, initially about once a week, now occurring less often.


Changed on 12/8/2009

VAERS ID: 284261 Before After
Age:17.0
Gender:Female
Location:California
Vaccinated:2007-01-02
Onset:2007-01-02
Submitted:2007-07-10
Entered:2007-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB129AA / 0 UN / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637F / 0 UN / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B014AA / 0 UN / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Loss of consciousness, Nuclear magnetic resonance imaging brain normal, Visual disturbance

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Allegra-D, Flonase, Ortho Tricyclen
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: MRI of brain was negative. Labs ordered but were not done.
CDC 'Split Type':

Write-up:On 4/11/2007, patient reported to me that after her 1st Gardisil vaccine on 01/02/2007, she had a /"blackout/" "blackout" feeling as she was leaving the office. This occurred again after the 2nd Gardisil vaccine was given on 3/28/2007.She stated that /"everything w"ent black/" "everything went black" and she could not see. She was very much alert and could hear, at that time. This episode lasted approximately 1 minute. These episodes have happened recurrently since that time, initially about once a week, now occurring less often.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=284261&WAYBACKHISTORY=ON


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