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This is VAERS ID 284775

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 284775
Age:18.0
Gender:Female
Location:Iowa
Vaccinated:2007-06-26
Onset:0000-00-00
Submitted:2007-07-16
Entered:2007-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U2181AA / 0 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B002AB / 0 LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Mydriasis, Pallor, Presyncope, Staring, Feeling of body temperature change

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Pt had a near syncopal episode but with quickly placing supine was averted. Pt. observed x 30 min. and left feeling fine. Pt had not eaten. Given water and crackers.
CDC 'Split Type':

Write-up:HPV#1 was given and pt c/o a warm feeling, she started to stare, pupils dilated and color went pale. Pt was quickly helped to a supine position and was responsive and did not have a loss of consciousness due to quick action


Changed on 12/8/2009

VAERS ID: 284775 Before After
Age:18.0
Gender:Female
Location:Iowa
Vaccinated:2007-06-26
Onset:0000-00-00
Submitted:2007-07-16
Entered:2007-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U2181AA / 0 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B002AB / 0 LA / IM

Administered by: Public      Purchased by: Unknown Other
Symptoms: Mydriasis, Pallor, Presyncope, Staring, Feeling of body temperature change

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Pt had a near syncopal episode but with quickly placing supine was averted. Pt. observed x 30 min. and left feeling fine. Pt had not eaten. Given water and crackers.
CDC 'Split Type':

Write-up:HPV#1 was given and pt c/o a warm feeling, she started to stare, pupils dilated and color went pale. Pt was quickly helped to a supine position and was responsive and did not have a loss of consciousness due to quick action


Changed on 4/7/2010

VAERS ID: 284775 Before After
Age:18.0
Gender:Female
Location:Iowa
Vaccinated:2007-06-26
Onset:0000-00-00
Submitted:2007-07-16
Entered:2007-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2181AA / 0 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B002AB / 0 LA / IM

Administered by: Public      Purchased by: Other
Symptoms: Mydriasis, Pallor, Presyncope, Staring, Feeling of body temperature change

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Pt had a near syncopal episode but with quickly placing supine was averted. Pt. observed x 30 min. and left feeling fine. Pt had not eaten. Given water and crackers.
CDC 'Split Type':

Write-up:HPV#1 was given and pt c/o a warm feeling, she started to stare, pupils dilated and color went pale. Pt was quickly helped to a supine position and was responsive and did not have a loss of consciousness due to quick action


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=284775&WAYBACKHISTORY=ON


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