National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 284774

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

284774
VAERS Form:
Age:16.0
Gender:Female
Location:California
Vaccinated:2007-07-13
Onset:0000-00-00
Submitted:2007-07-13
Entered:2007-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 01874 / 0 LA / UN
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U2223AA / 0 RA / UN

Administered by: Public      Purchased by: Unknown
Symptoms: Syncope, Immediate post-injection reaction

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:
Current Illness: None
Preexisting Conditions: Hx Allergic Rhinitis/Hx Syncope/Near Syncope Vasovagal Dx cleared by cardiology
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Syncope immediately post vaccination (Most likely vasovagal)


Changed on 12/8/2009

284774 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:California
Vaccinated:2007-07-13
Onset:0000-00-00 2007-07-13
Submitted:2007-07-13
Entered:2007-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 01874 / 0 LA / UN
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U2223AA / 0 RA / UN

Administered by: Public      Purchased by: Unknown
Symptoms: Syncope, Immediate post-injection reaction

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:
Current Illness: None
Preexisting Conditions: Hx Allergic Rhinitis/Hx Syncope/Near Syncope Vasovagal Dx cleared by cardiology
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Syncope immediately post vaccination (Most likely vasovagal)


Changed on 4/7/2010

284774 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:California
Vaccinated:2007-07-13
Onset:2007-07-13
Submitted:2007-07-13
Entered:2007-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 01874 / 0 LA / UN
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2223AA / 0 RA / UN

Administered by: Public      Purchased by: Unknown
Symptoms: Syncope, Immediate post-injection reaction

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:
Current Illness: None
Preexisting Conditions: Hx Allergic Rhinitis/Hx Syncope/Near Syncope Vasovagal Dx cleared by cardiology
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Syncope immediately post vaccination (Most likely vasovagal)


Changed on 9/14/2017

284774 Before After
VAERS Form:(blank) 1
Age:16.0
Gender:Female
Location:California
Vaccinated:2007-07-13
Onset:2007-07-13
Submitted:2007-07-13
Entered:2007-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 01874 / 0 1 LA / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2223AA / 0 1 RA / UN

Administered by: Public      Purchased by: Unknown
Symptoms: Syncope, Immediate post-injection reaction

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:
Current Illness: None
Preexisting Conditions: Hx Allergic Rhinitis/Hx Syncope/Near Syncope Vasovagal Dx cleared by cardiology
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Syncope immediately post vaccination (Most likely vasovagal)


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=284774&WAYBACKHISTORY=ON


Copyright © 2017 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166