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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: Unknown
CDC 'Split Type':

Write-up: Information has been received from a licensed practical nurse concerning a 16 year old female who was vaccinated IM with the second 0.5 ml dose of Gardasil. On 17-MAY-2007 after receiving the vaccine the patient fainted and was unconscious for a few secon"ds. The patient sought unspecified medical attention. No treatment was required. Subsequently, the patient recovered from fainting. The patient did not experience any adverse symptoms after the first dose. Additional information has been requested.

Changed on 12/8/2009

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: Unknown
CDC 'Split Type': (blank) WAES0706USA00033

Write-up: Information has been received from a licensed practical nurse concerning a 16 year old female who was vaccinated IM with the second 0.5 ml dose of Gardasil. On 17-MAY-2007 after receiving the vaccine the patient fainted and was unconscious for a few secon"ds. seconds. The patient sought unspecified medical attention. No treatment was required. Subsequently, the patient recovered from fainting. The patient did not experience any adverse symptoms after the first dose. Additional information has been requested.

Changed on 3/2/2010

Administered by: Other Private      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: Unknown
CDC 'Split Type': WAES0706USA00033

Write-up: This is in follow-up to report(s) previously submitted on 6/14/2007. Information has been received from a licensed practical nurse concerning a 16 year old female who was vaccinated IM with the second 0.5 ml dose of Gardasil. GARDASIL. On 17-MAY-2007 after receiving the vaccine the patient fainted and was unconscious for a few seconds. 1-2 minutes. The licensed practical nurse reported the patient complained of pain as injection was given and suddenly slumped in the chair. They were able to arouse the patient by calling her name. The staff watched the patient for 10-15 minutes after she was asked to lie down. The patient reported to the staff that she thought she was swimming. The patient recovered quickly and was clear and ambulatory when she left the clinic. The patient sought unspecified medical attention. No treatment was required. Subsequently, the patient recovered from fainting. The patient did not experience any adverse symptoms after the first dose. Additional No additional information has been requested. is expected.

Changed on 4/7/2010

Administered by: Private      Purchased by: Other
Symptoms: Hypotonia, Injection site pain, 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: Unknown
CDC 'Split Type': WAES0706USA00033

Write-up: This is in follow-up to report(s) previously submitted on 6/14/2007. Information has been received from a licensed practical nurse concerning a 16 year old female who was vaccinated IM with the second 0.5 ml dose of GARDASIL. On 17-MAY-2007 after receiving the vaccine the patient fainted and was unconscious for 1-2 minutes. The licensed practical nurse reported the patient complained of pain as injection was given and suddenly slumped in the chair. They were able to arouse the patient by calling her name. The staff watched the patient for 10-15 minutes after she was asked to lie down. The patient reported to the staff that she thought she was swimming. The patient recovered quickly and was clear and ambulatory when she left the clinic. The patient sought unspecified medical attention. No treatment was required. Subsequently, the patient recovered from fainting. The patient did not experience any adverse symptoms after the first dose. No additional information is expected.

Changed on 6/14/2014

Administered by: Private      Purchased by: Other
Symptoms: Hypotonia, Injection site pain, 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: Unknown
CDC 'Split Type': WAES0706USA00033

Write-up: This is in follow-up to report(s) previously submitted on 6/14/2007. Information has been received from a licensed practical nurse concerning a 16 year old female who was vaccinated IM with the second 0.5 ml dose of GARDASIL. On 17-MAY-2007 after receiving the vaccine the patient fainted and was unconscious for 1-2 minutes. The licensed practical nurse reported the patient complained of pain as injection was given and suddenly slumped in the chair. They were able to arouse the patient by calling her name. The staff watched the patient for 10-15 minutes after she was asked to lie down. The patient reported to the staff that she thought she was swimming. The patient recovered quickly and was clear and ambulatory when she left the clinic. The patient sought unspecified medical attention. No treatment was required. Subsequently, the patient recovered from fainting. The patient did not experience any adverse symptoms after the first dose. No additional information is expected.

Changed on 5/14/2017

Administered by: Private      Purchased by: Other
Symptoms: Hypotonia, Injection site pain, 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: Unknown
CDC 'Split Type': WAES0706USA00033

Write-up: This is in follow-up to report(s) previously submitted on 6/14/2007. Information has been received from a licensed practical nurse concerning a 16 year old female who was vaccinated IM with the second 0.5 ml dose of GARDASIL. On 17-MAY-2007 after receiving the vaccine the patient fainted and was unconscious for 1-2 minutes. The licensed practical nurse reported the patient complained of pain as injection was given and suddenly slumped in the chair. They were able to arouse the patient by calling her name. The staff watched the patient for 10-15 minutes after she was asked to lie down. The patient reported to the staff that she thought she was swimming. The patient recovered quickly and was clear and ambulatory when she left the clinic. The patient sought unspecified medical attention. No treatment was required. Subsequently, the patient recovered from fainting. The patient did not experience any adverse symptoms after the first dose. No additional information is expected.

Changed on 9/14/2017

Administered by: Private      Purchased by: Other
Symptoms: Hypotonia, Injection site pain, 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: Unknown
CDC 'Split Type': WAES0706USA00033

Write-up: This is in follow-up to report(s) previously submitted on 6/14/2007. Information has been received from a licensed practical nurse concerning a 16 year old female who was vaccinated IM with the second 0.5 ml dose of GARDASIL. On 17-MAY-2007 after receiving the vaccine the patient fainted and was unconscious for 1-2 minutes. The licensed practical nurse reported the patient complained of pain as injection was given and suddenly slumped in the chair. They were able to arouse the patient by calling her name. The staff watched the patient for 10-15 minutes after she was asked to lie down. The patient reported to the staff that she thought she was swimming. The patient recovered quickly and was clear and ambulatory when she left the clinic. The patient sought unspecified medical attention. No treatment was required. Subsequently, the patient recovered from fainting. The patient did not experience any adverse symptoms after the first dose. No additional information is expected.

Changed on 2/14/2018

Administered by: Private      Purchased by: Other
Symptoms: Hypotonia, Injection site pain, 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: Unknown
CDC 'Split Type': WAES0706USA00033

Write-up: This is in follow-up to report(s) previously submitted on 6/14/2007. Information has been received from a licensed practical nurse concerning a 16 year old female who was vaccinated IM with the second 0.5 ml dose of GARDASIL. On 17-MAY-2007 after receiving the vaccine the patient fainted and was unconscious for 1-2 minutes. The licensed practical nurse reported the patient complained of pain as injection was given and suddenly slumped in the chair. They were able to arouse the patient by calling her name. The staff watched the patient for 10-15 minutes after she was asked to lie down. The patient reported to the staff that she thought she was swimming. The patient recovered quickly and was clear and ambulatory when she left the clinic. The patient sought unspecified medical attention. No treatment was required. Subsequently, the patient recovered from fainting. The patient did not experience any adverse symptoms after the first dose. No additional information is expected.

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