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This is VAERS ID 284465

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

284465
VAERS Form:
Age:
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
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR - / - UN / UN
VARCEL: VARICELLA (VARIVAX) / 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? 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0705USA04235

Write-up:Information has been received from a nurse practitioner concerning a female with no known allergies who was vaccinated with a dose of Gardasil, Varivax (MSD), MENACTRA and DTaP. Subsequently, the patient experienced syncope that lasted two to three minutes. It was reported that the patient required no treatment, hospitalization or resuscitation and had no illness at the time of vaccination. The patient was recovered. Additional information has been requested.


Changed on 4/7/2010

284465 Before After
VAERS Form:
Age:
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
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR - / - UN / UN
VARCEL: VARICELLA (VARIVAX) / 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? 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0705USA04235

Write-up:Information has been received from a nurse practitioner concerning a female with no known allergies who was vaccinated with a dose of Gardasil, Varivax (MSD), MENACTRA and DTaP. Subsequently, the patient experienced syncope that lasted two to three minutes. It was reported that the patient required no treatment, hospitalization or resuscitation and had no illness at the time of vaccination. The patient was recovered. Additional information has been requested.


Changed on 9/14/2017

284465 Before After
VAERS Form:(blank) 1
Age:
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
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UNK UN / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR - / - UNK UN / UN
VARCEL: VARICELLA (VARIVAX) / 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? 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0705USA04235

Write-up:Information has been received from a nurse practitioner concerning a female with no known allergies who was vaccinated with a dose of Gardasil, Varivax (MSD), MENACTRA and DTaP. Subsequently, the patient experienced syncope that lasted two to three minutes. It was reported that the patient required no treatment, hospitalization or resuscitation and had no illness at the time of vaccination. The patient was recovered. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=284465&WAYBACKHISTORY=ON


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