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This is VAERS ID 284561

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

284561
VAERS Form:
Age:18.0
Gender:Female
Location:California
Vaccinated:2007-04-30
Onset:2007-04-30
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: Unknown
CDC 'Split Type':

Write-up:Information has been received from a physician concerning an 18 year old female who on approximately 30-APR-2007 was vaccinated with the first dose of Gardasil. It was reported that as the patient was leaving the medical office, she lost consciousness and"fainted. The patient regained consciousness and remained in the office for a period of time for observation and was given liquids. The patient recovered and subsequently left the office. Additional information has been requested.


Changed on 12/8/2009

284561 Before After
VAERS Form:
Age:18.0
Gender:Female
Location:California
Vaccinated:2007-04-30
Onset:2007-04-30
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: Unknown
CDC 'Split Type': (blank) WAES0706USA00049

Write-up:Information has been received from a physician concerning an 18 year old female who on approximately 30-APR-2007 was vaccinated with the first dose of Gardasil. It was reported that as the patient was leaving the medical office, she lost consciousness and"fainted. and fainted. The patient regained consciousness and remained in the office for a period of time for observation and was given liquids. The patient recovered and subsequently left the office. Additional information has been requested.


Changed on 9/14/2017

284561 Before After
VAERS Form:(blank) 1
Age:18.0
Gender:Female
Location:California
Vaccinated:2007-04-30
Onset:2007-04-30
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: Unknown
CDC 'Split Type': WAES0706USA00049

Write-up:Information has been received from a physician concerning an 18 year old female who on approximately 30-APR-2007 was vaccinated with the first dose of Gardasil. It was reported that as the patient was leaving the medical office, she lost consciousness and fainted. The patient regained consciousness and remained in the office for a period of time for observation and was given liquids. The patient recovered and subsequently left the office. Additional information has been requested.


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Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=284561&WAYBACKHISTORY=ON


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