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This is VAERS ID 284492

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

284492
VAERS Form:
Age:15.0
Gender:Female
Location:Unknown
Vaccinated:2007-04-01
Onset:2007-04-01
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - - / -

Administered by: Unknown      Purchased by: Unknown
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)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Information has been received from a physician concerning a 15 year old female who in April 2007, was vaccinated with Gardasil. There was no concomitant medication. In April 2007, the patient fainted after receiving the vaccine. It was reported that the p"atient''''s blood pressure was taken. No further details were provided. Additional information has been requested.


Changed on 12/8/2009

284492 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:Unknown
Vaccinated:2007-04-01
Onset:2007-04-01
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - - / -

Administered by: Unknown      Purchased by: Unknown
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)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) WAES0705USA05033

Write-up:Information has been received from a physician concerning a 15 year old female who in April 2007, was vaccinated with Gardasil. There was no concomitant medication. In April 2007, the patient fainted after receiving the vaccine. It was reported that the p"atient''''s patient''s blood pressure was taken. No further details were provided. Additional information has been requested.


Changed on 9/14/2017

284492 Before After
VAERS Form:(blank) 1
Age:15.0
Gender:Female
Location:Unknown
Vaccinated:2007-04-01
Onset:2007-04-01
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UNK - / -

Administered by: Unknown      Purchased by: Unknown
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)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0705USA05033

Write-up:Information has been received from a physician concerning a 15 year old female who in April 2007, was vaccinated with Gardasil. There was no concomitant medication. In April 2007, the patient fainted after receiving the vaccine. It was reported that the patient''s blood pressure was taken. No further details were provided. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=284492&WAYBACKHISTORY=ON


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