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This is VAERS ID 307011

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2008

VAERS ID: 307011
VAERS Form:
Age:15.0
Gender:Female
Location:Georgia
Vaccinated:2008-03-08
Onset:2008-03-08
Submitted:2008-03-13
Entered:2008-03-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB217BA / - LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1508U / 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Pain in extremity, Pallor, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: Fainting~ ()~~0~In Patient
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': None

Write-up: Administered HPV (Gardasil) vaccine #1 in child''''s left deltoid. Patient fainted. I put ammonia under her nose. She woke up but was very pale and complained of her legs hurting. She then put her head between her legs and she began to feel better.


Changed on 12/8/2009

VAERS ID: 307011 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:Georgia
Vaccinated:2008-03-08
Onset:2008-03-08
Submitted:2008-03-13
Entered:2008-03-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB217BA / - LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1508U / 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Pain in extremity, Pallor, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: Fainting~ ()~~0~In Patient
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': None (blank)

Write-up: Administered HPV (Gardasil) vaccine #1 in child''''s child''s left deltoid. Patient fainted. I put ammonia under her nose. She woke up but was very pale and complained of her legs hurting. She then put her head between her legs and she began to feel better.


Changed on 4/14/2017

VAERS ID: 307011 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:Georgia
Vaccinated:2008-03-08
Onset:2008-03-08
Submitted:2008-03-13
Entered:2008-03-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB217BA / - LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1508U / 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Pain in extremity, Pallor, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: Fainting~ ()~~0~In ()~~0.00~In Patient
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Administered HPV (Gardasil) vaccine #1 in child''s left deltoid. Patient fainted. I put ammonia under her nose. She woke up but was very pale and complained of her legs hurting. She then put her head between her legs and she began to feel better.


Changed on 9/14/2017

VAERS ID: 307011 Before After
VAERS Form:(blank) 1
Age:15.0
Gender:Female
Location:Georgia
Vaccinated:2008-03-08
Onset:2008-03-08
Submitted:2008-03-13
Entered:2008-03-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB217BA / - UNK LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1508U / 1 2 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Pain in extremity, Pallor, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: Fainting~ ()~~0.00~In Patient
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Administered HPV (Gardasil) vaccine #1 in child''s left deltoid. Patient fainted. I put ammonia under her nose. She woke up but was very pale and complained of her legs hurting. She then put her head between her legs and she began to feel better.


Changed on 2/14/2018

VAERS ID: 307011 Before After
VAERS Form:1
Age:15.0
Gender:Female
Location:Georgia
Vaccinated:2008-03-08
Onset:2008-03-08
Submitted:2008-03-13
Entered:2008-03-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB217BA / UNK LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1508U / 2 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Pain in extremity, Pallor, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: Fainting~ ()~~0.00~In Patient
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Administered HPV (Gardasil) vaccine #1 in child''s left deltoid. Patient fainted. I put ammonia under her nose. She woke up but was very pale and complained of her legs hurting. She then put her head between her legs and she began to feel better.


Changed on 6/14/2018

VAERS ID: 307011 Before After
VAERS Form:1
Age:15.0
Gender:Female
Location:Georgia
Vaccinated:2008-03-08
Onset:2008-03-08
Submitted:2008-03-13
Entered:2008-03-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB217BA / UNK LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1508U / 2 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Pain in extremity, Pallor, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: Fainting~ ()~~0.00~In Patient
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Administered HPV (Gardasil) vaccine #1 in child''s left deltoid. Patient fainted. I put ammonia under her nose. She woke up but was very pale and complained of her legs hurting. She then put her head between her legs and she began to feel better.


Changed on 8/14/2018

VAERS ID: 307011 Before After
VAERS Form:1
Age:15.0
Gender:Female
Location:Georgia
Vaccinated:2008-03-08
Onset:2008-03-08
Submitted:2008-03-13
Entered:2008-03-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB217BA / UNK LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1508U / 2 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Pain in extremity, Pallor, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: Fainting~ ()~~0.00~In Patient
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Administered HPV (Gardasil) vaccine #1 in child''s left deltoid. Patient fainted. I put ammonia under her nose. She woke up but was very pale and complained of her legs hurting. She then put her head between her legs and she began to feel better.


Changed on 9/14/2018

VAERS ID: 307011 Before After
VAERS Form:1
Age:15.0
Gender:Female
Location:Georgia
Vaccinated:2008-03-08
Onset:2008-03-08
Submitted:2008-03-13
Entered:2008-03-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB217BA / UNK LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1508U / 2 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Pain in extremity, Pallor, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: Fainting~ ()~~0.00~In Patient
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Administered HPV (Gardasil) vaccine #1 in child''s left deltoid. Patient fainted. I put ammonia under her nose. She woke up but was very pale and complained of her legs hurting. She then put her head between her legs and she began to feel better.

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=307011&WAYBACKHISTORY=ON


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