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This is VAERS ID 284551

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

284551
VAERS Form:
Age:
Gender:Female
Location:Unknown
Vaccinated:2006-11-22
Onset:2006-11-22
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / UN

Administered by: Other      Purchased by: Unknown
Symptoms: Loss of consciousness, 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)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Information has been received from a physician concerning a female who on 22-NOV-2006 was vaccinated with Gardasil. On 22-NOV-2006 the patient passed out in the lobby 5 minutes after she was vaccinated. The patient recovered. It was noted that the patient"''''s mother has a history of syncope. Subsequently, the patient received dose 2 and dose 3 without any adverse experience. Additional information has been requested.


Changed on 12/8/2009

284551 Before After
VAERS Form:
Age:
Gender:Female
Location:Unknown
Vaccinated:2006-11-22
Onset:2006-11-22
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / UN

Administered by: Other      Purchased by: Unknown Other
Symptoms: Loss of consciousness, 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)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) WAES0706USA00023

Write-up:Information has been received from a physician concerning a female who on 22-NOV-2006 was vaccinated with Gardasil. On 22-NOV-2006 the patient passed out in the lobby 5 minutes after she was vaccinated. The patient recovered. It was noted that the patient"''''s patient''s mother has a history of syncope. Subsequently, the patient received dose 2 and dose 3 without any adverse experience. Additional information has been requested.


Changed on 9/14/2017

284551 Before After
VAERS Form:(blank) 1
Age:
Gender:Female
Location:Unknown
Vaccinated:2006-11-22
Onset:2006-11-22
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Loss of consciousness, 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)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0706USA00023

Write-up:Information has been received from a physician concerning a female who on 22-NOV-2006 was vaccinated with Gardasil. On 22-NOV-2006 the patient passed out in the lobby 5 minutes after she was vaccinated. The patient recovered. It was noted that the patient''s mother has a history of syncope. Subsequently, the patient received dose 2 and dose 3 without any adverse experience. Additional information has been requested.


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Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=284551&WAYBACKHISTORY=ON


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