National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 294675

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

294675
VAERS Form:
Age:14.0
Gender:Female
Location:Unknown
Vaccinated:2007-10-26
Onset:2007-10-26
Submitted:2007-10-29
Entered:2007-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Asthenia, Dizziness, Loss of consciousness, Gaze palsy

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: None~ ()~~0~In Patient|None~ ()~~0~In Sibling
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': None

Write-up:Within 10 minutes of receiving the Gardasil vaccination (she also received a flu shot in the other arm) patient said she felt like she was /"going to pass out/". The nurse had patient lay down on the examination table and brought up the leg support. Pat"ient''''s eyes rolled back in her head, her legs twitched, and she stopped breathing. She was unconscious for about 20 seconds. When I started screaming that Patient was not breathing, the nurse called a code in the office. Staff came with the equipment,


Changed on 12/8/2009

294675 Before After
VAERS Form:
Age:14.0
Gender:Female
Location:Unknown
Vaccinated:2007-10-26
Onset:2007-10-26
Submitted:2007-10-29
Entered:2007-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Asthenia, Dizziness, Loss of consciousness, Muscle twitching, Nausea, Respiratory arrest, Gaze palsy

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: None~ ()~~0~In Patient|None~ ()~~0~In Sibling
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': None (blank)

Write-up:Within 10 minutes of receiving the Gardasil vaccination (she also received a flu shot in the other arm) patient said she felt like she was /"going "going to pass out/". out". The nurse had patient lay down on the examination table and brought up the leg support. Pat"ient''''s Patient''s eyes rolled back in her head, her legs twitched, and she stopped breathing. She was unconscious for about 20 seconds. When I started screaming that Patient was not breathing, the nurse called a code in the office. Staff came with the equipment, but by that time patient had regained consciousness. When she did "come to", patient felt that she was going to vomit. She did not vomit, but remained very weak and had to be transported to the car by wheelchair, and was then assisted into the house by her older sister. Patient slept for about 4 hours after the incident.


Changed on 4/14/2017

294675 Before After
VAERS Form:
Age:14.0
Gender:Female
Location:Unknown
Vaccinated:2007-10-26
Onset:2007-10-26
Submitted:2007-10-29
Entered:2007-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Asthenia, Dizziness, Loss of consciousness, Muscle twitching, Nausea, Respiratory arrest, Gaze palsy

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: None~ ()~~0~In ()~~0.00~In Patient|None~ ()~~0~In ()~~0.00~In Sibling
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Within 10 minutes of receiving the Gardasil vaccination (she also received a flu shot in the other arm) patient said she felt like she was "going to pass out". The nurse had patient lay down on the examination table and brought up the leg support. Patient''s eyes rolled back in her head, her legs twitched, and she stopped breathing. She was unconscious for about 20 seconds. When I started screaming that Patient was not breathing, the nurse called a code in the office. Staff came with the equipment, but by that time patient had regained consciousness. When she did "come to", patient felt that she was going to vomit. She did not vomit, but remained very weak and had to be transported to the car by wheelchair, and was then assisted into the house by her older sister. Patient slept for about 4 hours after the incident.


Changed on 9/14/2017

294675 Before After
VAERS Form:(blank) 1
Age:14.0
Gender:Female
Location:Unknown
Vaccinated:2007-10-26
Onset:2007-10-26
Submitted:2007-10-29
Entered:2007-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Asthenia, Dizziness, Loss of consciousness, Muscle twitching, Nausea, Respiratory arrest, Gaze palsy

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: None~ ()~~0.00~In Patient|None~ ()~~0.00~In Sibling
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Within 10 minutes of receiving the Gardasil vaccination (she also received a flu shot in the other arm) patient said she felt like she was "going to pass out". The nurse had patient lay down on the examination table and brought up the leg support. Patient''s eyes rolled back in her head, her legs twitched, and she stopped breathing. She was unconscious for about 20 seconds. When I started screaming that Patient was not breathing, the nurse called a code in the office. Staff came with the equipment, but by that time patient had regained consciousness. When she did "come to", patient felt that she was going to vomit. She did not vomit, but remained very weak and had to be transported to the car by wheelchair, and was then assisted into the house by her older sister. Patient slept for about 4 hours after the incident.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=294675&WAYBACKHISTORY=ON


Copyright © 2018 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166