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This is VAERS ID 284401

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 284401
VAERS Form:
Age:14.0
Gender:Female
Location:Kansas
Vaccinated:2007-07-09
Onset:2007-07-09
Submitted:2007-07-09
Entered:2007-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 0 LA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC528009AA / 5 RA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Blood pressure decreased, Nausea, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Fainted/nausea/decreased BP - Trendelenberg used. Unable to get a B/P but pt was alert. B/P after 10 min was 100/58 (normal per pt)


Changed on 9/14/2017

VAERS ID: 284401 Before After
VAERS Form:(blank) 1
Age:14.0
Gender:Female
Location:Kansas
Vaccinated:2007-07-09
Onset:2007-07-09
Submitted:2007-07-09
Entered:2007-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 0 1 LA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC528009AA / 5 6 RA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Blood pressure decreased, Nausea, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Fainted/nausea/decreased BP - Trendelenberg used. Unable to get a B/P but pt was alert. B/P after 10 min was 100/58 (normal per pt)


Changed on 2/14/2018

VAERS ID: 284401 Before After
VAERS Form:1
Age:14.0
Gender:Female
Location:Kansas
Vaccinated:2007-07-09
Onset:2007-07-09
Submitted:2007-07-09
Entered:2007-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 1 LA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC528009AA / 6 RA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Blood pressure decreased, Nausea, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Fainted/nausea/decreased BP - Trendelenberg used. Unable to get a B/P but pt was alert. B/P after 10 min was 100/58 (normal per pt)

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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=284401&WAYBACKHISTORY=ON


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