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This is VAERS ID 284464

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

284464
VAERS Form:
Age:20.0
Gender:Female
Location:Unknown
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: Other
Symptoms: Syncope

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0705USA04232

Write-up:Information has been received from a medical assistant concerning a 20 year old female who in approximately April 2007, was vaccinated with a dose of Gardasil. In approximately April 2007, the patient experienced syncope when receiving the vaccination. At the time of the report, the patient''s outcome was unknown. Additional information has been requested.


Changed on 9/14/2017

284464 Before After
VAERS Form:(blank) 1
Age:20.0
Gender:Female
Location:Unknown
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. - / - UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Syncope

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0705USA04232

Write-up:Information has been received from a medical assistant concerning a 20 year old female who in approximately April 2007, was vaccinated with a dose of Gardasil. In approximately April 2007, the patient experienced syncope when receiving the vaccination. At the time of the report, the patient''s outcome was unknown. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=284464&WAYBACKHISTORY=ON


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