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This is VAERS ID 284507

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

284507
VAERS Form:
Age:
Gender:Female
Location:New York
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. - / - - / IM

Administered by: Other      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)? 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':

Write-up:Initial information has been received from a physician and follow up information has been received from a nurse concerning a female patient between the ages of 11 and 19 who was vaccinated IM with a dose of Gardasil. It was reported that the patient sat f"or a minute (after receiving the injection) and when she got up to leave she fainted in the hallway. Her outcome was not reported. The physician reported that lot numbers were not available, however, the physician will forward other information including


Changed on 12/8/2009

284507 Before After
VAERS Form:
Age:
Gender:Female
Location:New York
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. - / - - / IM

Administered by: Other      Purchased by: Unknown 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': (blank) WAES0705USA05339

Write-up:Initial information has been received from a physician and follow up information has been received from a nurse concerning a female patient between the ages of 11 and 19 who was vaccinated IM with a dose of Gardasil. It was reported that the patient sat f"or for a minute (after receiving the injection) and when she got up to leave she fainted in the hallway. Her outcome was not reported. The physician reported that lot numbers were not available, however, the physician will forward other information including the lot numbers. Additional information has been requested.


Changed on 3/2/2010

284507 Before After
VAERS Form:
Age:(blank) 14.0
Gender:Female
Location:New York
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. - 0384U / - 0 - / IM

Administered by: Other Private      Purchased by: Other Private
Symptoms: Syncope

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No 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 None
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0705USA05339

Write-up:Initial information has been received from a physician and follow up information has been received from a nurse concerning a female patient between the ages of 11 and 19 who was vaccinated IM with a dose of Gardasil. It was reported that the patient sat for a minute (after receiving the injection) and when she got up to leave she fainted in the hallway. Her outcome was not reported. The physician reported that lot numbers were not available, however, the physician will forward other information including the lot numbers. Additional information has been requested. requested.This is in follow-up to report (s) previously submitted on 6/14/2007. Follow-up information has been received from a healthcare professional concerning the 14 year old female student who on 26-Apr-2007 at 2:15 p.m. received her first IM dose of GARDASIL, LOT # 657617/0384u. At 2:15 p.m. the patient experienced dizziness (also reported as within 5 minutes of receiving immunization patient excperienced dizziness). The patient laid down on the exam table and was "within normal limits after 10 minutes on the table". No treatment was necessary. Addional information is not expected.


Changed on 4/7/2010

284507 Before After
VAERS Form:
Age:14.0
Gender:Female
Location:New York
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. 0384U / 0 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Dizziness, 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: None
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0705USA05339

Write-up:Initial information has been received from a physician and follow up information has been received from a nurse concerning a female patient between the ages of 11 and 19 who was vaccinated IM with a dose of Gardasil. It was reported that the patient sat for a minute (after receiving the injection) and when she got up to leave she fainted in the hallway. Her outcome was not reported. The physician reported that lot numbers were not available, however, the physician will forward other information including the lot numbers. Additional information has been requested.This is in follow-up to report (s) previously submitted on 6/14/2007. Follow-up information has been received from a healthcare professional concerning the 14 year old female student who on 26-Apr-2007 at 2:15 p.m. received her first IM dose of GARDASIL, LOT # 657617/0384u. At 2:15 p.m. the patient experienced dizziness (also reported as within 5 minutes of receiving immunization patient excperienced dizziness). The patient laid down on the exam table and was "within normal limits after 10 minutes on the table". No treatment was necessary. Addional information is not expected.


Changed on 6/14/2014

284507 Before After
VAERS Form:
Age:14.0
Gender:Female
Location:New York
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. 0384U / 0 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Dizziness, 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: None
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0705USA05339

Write-up:Initial information has been received from a physician and follow up information has been received from a nurse concerning a female patient between the ages of 11 and 19 who was vaccinated IM with a dose of Gardasil. It was reported that the patient sat for a minute (after receiving the injection) and when she got up to leave she fainted in the hallway. Her outcome was not reported. The physician reported that lot numbers were not available, however, the physician will forward other information including the lot numbers. Additional information has been requested.This is in follow-up to report (s) previously submitted on 6/14/2007. Follow-up information has been received from a healthcare professional concerning the 14 year old female student who on 26-Apr-2007 at 2:15 p.m. received her first IM dose of GARDASIL, LOT # 657617/0384u. At 2:15 p.m. the patient experienced dizziness (also reported as within 5 minutes of receiving immunization patient excperienced dizziness). The patient laid down on the exam table and was "within normal limits after 10 minutes on the table". No treatment was necessary. Addional information is not expected.


Changed on 5/14/2017

284507 Before After
VAERS Form:
Age:14.0
Gender:Female
Location:New York
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. 0384U / 0 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Dizziness, 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: None
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0705USA05339

Write-up:Initial information has been received from a physician and follow up information has been received from a nurse concerning a female patient between the ages of 11 and 19 who was vaccinated IM with a dose of Gardasil. It was reported that the patient sat for a minute (after receiving the injection) and when she got up to leave she fainted in the hallway. Her outcome was not reported. The physician reported that lot numbers were not available, however, the physician will forward other information including the lot numbers. Additional information has been requested.This is in follow-up to report (s) previously submitted on 6/14/2007. Follow-up information has been received from a healthcare professional concerning the 14 year old female student who on 26-Apr-2007 at 2:15 p.m. received her first IM dose of GARDASIL, LOT # 657617/0384u. At 2:15 p.m. the patient experienced dizziness (also reported as within 5 minutes of receiving immunization patient excperienced dizziness). The patient laid down on the exam table and was "within normal limits after 10 minutes on the table". No treatment was necessary. Addional information is not expected.


Changed on 9/14/2017

284507 Before After
VAERS Form:(blank) 1
Age:14.0
Gender:Female
Location:New York
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. 0384U / 0 1 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Dizziness, 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: None
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0705USA05339

Write-up:Initial information has been received from a physician and follow up information has been received from a nurse concerning a female patient between the ages of 11 and 19 who was vaccinated IM with a dose of Gardasil. It was reported that the patient sat for a minute (after receiving the injection) and when she got up to leave she fainted in the hallway. Her outcome was not reported. The physician reported that lot numbers were not available, however, the physician will forward other information including the lot numbers. Additional information has been requested.This is in follow-up to report (s) previously submitted on 6/14/2007. Follow-up information has been received from a healthcare professional concerning the 14 year old female student who on 26-Apr-2007 at 2:15 p.m. received her first IM dose of GARDASIL, LOT # 657617/0384u. At 2:15 p.m. the patient experienced dizziness (also reported as within 5 minutes of receiving immunization patient excperienced dizziness). The patient laid down on the exam table and was "within normal limits after 10 minutes on the table". No treatment was necessary. Addional information is not expected.


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