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This is VAERS ID 291407

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 291407
VAERS Form:
Age:16.0
Sex:Female
Location:New Jersey
Vaccinated:2007-09-10
Onset:2007-09-10
Submitted:2007-09-17
Entered:2007-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1425F / 2 LA / UN

Administered by: Private      Purchased by: Unknown
Symptoms: Bradycardia, Dizziness, Mental status changes

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: Claritin prn only
Current Illness: None
Preexisting Conditions: Motrin
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: dizziness, bradycardia, change of mental status no loss of consciousness, no anaphylactic vasovagal O2 given and IVF referred to ER recovered successfully.


Changed on 12/8/2009

VAERS ID: 291407 Before After
VAERS Form:
Age:16.0
Sex:Female
Location:New Jersey
Vaccinated:2007-09-10
Onset:2007-09-10
Submitted:2007-09-17
Entered:2007-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1425F / 2 LA / UN

Administered by: Private      Purchased by: Unknown Other
Symptoms: Bradycardia, Dizziness, Mental status changes

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: Claritin prn only
Current Illness: None
Preexisting Conditions: Motrin
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: dizziness, bradycardia, change of mental status no loss of consciousness, no anaphylactic vasovagal O2 given and IVF referred to ER recovered successfully.


Changed on 9/14/2017

VAERS ID: 291407 Before After
VAERS Form:(blank) 1
Age:16.0
Sex:Female
Location:New Jersey
Vaccinated:2007-09-10
Onset:2007-09-10
Submitted:2007-09-17
Entered:2007-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1425F / 2 3 LA / UN

Administered by: Private      Purchased by: Other
Symptoms: Bradycardia, Dizziness, Mental status changes

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: Claritin prn only
Current Illness: None
Preexisting Conditions: Motrin
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: dizziness, bradycardia, change of mental status no loss of consciousness, no anaphylactic vasovagal O2 given and IVF referred to ER recovered successfully.


Changed on 2/14/2018

VAERS ID: 291407 Before After
VAERS Form:1
Age:16.0
Sex:Female
Location:New Jersey
Vaccinated:2007-09-10
Onset:2007-09-10
Submitted:2007-09-17
Entered:2007-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1425F / 3 LA / UN

Administered by: Private      Purchased by: Other
Symptoms: Bradycardia, Dizziness, Mental status changes

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: Claritin prn only
Current Illness: None
Preexisting Conditions: Motrin
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: dizziness, bradycardia, change of mental status no loss of consciousness, no anaphylactic vasovagal O2 given and IVF referred to ER recovered successfully.


Changed on 6/14/2018

VAERS ID: 291407 Before After
VAERS Form:1
Age:16.0
Sex:Female
Location:New Jersey
Vaccinated:2007-09-10
Onset:2007-09-10
Submitted:2007-09-17
Entered:2007-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1425F / 3 LA / UN

Administered by: Private      Purchased by: Other
Symptoms: Bradycardia, Dizziness, Mental status changes

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: Claritin prn only
Current Illness: None
Preexisting Conditions: Motrin
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: dizziness, bradycardia, change of mental status no loss of consciousness, no anaphylactic vasovagal O2 given and IVF referred to ER recovered successfully.


Changed on 8/14/2018

VAERS ID: 291407 Before After
VAERS Form:1
Age:16.0
Sex:Female
Location:New Jersey
Vaccinated:2007-09-10
Onset:2007-09-10
Submitted:2007-09-17
Entered:2007-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1425F / 3 LA / UN

Administered by: Private      Purchased by: Other
Symptoms: Bradycardia, Dizziness, Mental status changes

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: Claritin prn only
Current Illness: None
Preexisting Conditions: Motrin
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: dizziness, bradycardia, change of mental status no loss of consciousness, no anaphylactic vasovagal O2 given and IVF referred to ER recovered successfully.


Changed on 9/14/2018

VAERS ID: 291407 Before After
VAERS Form:1
Age:16.0
Sex:Female
Location:New Jersey
Vaccinated:2007-09-10
Onset:2007-09-10
Submitted:2007-09-17
Entered:2007-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1425F / 3 LA / UN

Administered by: Private      Purchased by: Other
Symptoms: Bradycardia, Dizziness, Mental status changes

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: Claritin prn only
Current Illness: None
Preexisting Conditions: Motrin
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: dizziness, bradycardia, change of mental status no loss of consciousness, no anaphylactic vasovagal O2 given and IVF referred to ER recovered successfully.


Changed on 10/14/2018

VAERS ID: 291407 Before After
VAERS Form:1
Age:16.0
Sex:Female
Location:New Jersey
Vaccinated:2007-09-10
Onset:2007-09-10
Submitted:2007-09-17
Entered:2007-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1425F / 3 LA / UN

Administered by: Private      Purchased by: Other
Symptoms: Bradycardia, Dizziness, Mental status changes

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: Claritin prn only
Current Illness: None
Preexisting Conditions: Motrin
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: dizziness, bradycardia, change of mental status no loss of consciousness, no anaphylactic vasovagal O2 given and IVF referred to ER recovered successfully.

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