National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 321093

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2008

VAERS ID: 321093
VAERS Form:
Age:13.0
Gender:Female
Location:Tennessee
Vaccinated:2008-07-23
Onset:2008-07-23
Submitted:2008-08-01
Entered:2008-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER 1740U 8/10 / 1 RA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Fall, 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:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: After receiving Gardasil patient fainted and fell to floor. Patient''''s vital signs were taken and monitored for about 30 mins after episode.


Changed on 12/8/2009

VAERS ID: 321093 Before After
VAERS Form:
Age:13.0
Gender:Female
Location:Tennessee
Vaccinated:2008-07-23
Onset:2008-07-23
Submitted:2008-08-01
Entered:2008-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER 1740U 8/10 / 1 RA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Fall, 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:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: After receiving Gardasil patient fainted and fell to floor. Patient''''s Patient''s vital signs were taken and monitored for about 30 mins after episode.


Changed on 9/14/2017

VAERS ID: 321093 Before After
VAERS Form:(blank) 1
Age:13.0
Gender:Female
Location:Tennessee
Vaccinated:2008-07-23
Onset:2008-07-23
Submitted:2008-08-01
Entered:2008-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER 1740U 8/10 / 1 2 RA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Fall, 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:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: After receiving Gardasil patient fainted and fell to floor. Patient''s vital signs were taken and monitored for about 30 mins after episode.


Changed on 2/14/2018

VAERS ID: 321093 Before After
VAERS Form:1
Age:13.0
Gender:Female
Location:Tennessee
Vaccinated:2008-07-23
Onset:2008-07-23
Submitted:2008-08-01
Entered:2008-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER 1740U 8/10 / 2 RA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Fall, 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:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: After receiving Gardasil patient fainted and fell to floor. Patient''s vital signs were taken and monitored for about 30 mins after episode.


Changed on 6/14/2018

VAERS ID: 321093 Before After
VAERS Form:1
Age:13.0
Gender:Female
Location:Tennessee
Vaccinated:2008-07-23
Onset:2008-07-23
Submitted:2008-08-01
Entered:2008-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER 1740U 8/10 / 2 RA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Fall, 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:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: After receiving Gardasil patient fainted and fell to floor. Patient''s vital signs were taken and monitored for about 30 mins after episode.


Changed on 8/14/2018

VAERS ID: 321093 Before After
VAERS Form:1
Age:13.0
Gender:Female
Location:Tennessee
Vaccinated:2008-07-23
Onset:2008-07-23
Submitted:2008-08-01
Entered:2008-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER 1740U 8/10 / 2 RA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Fall, 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:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: After receiving Gardasil patient fainted and fell to floor. Patient''s vital signs were taken and monitored for about 30 mins after episode.


Changed on 9/14/2018

VAERS ID: 321093 Before After
VAERS Form:1
Age:13.0
Gender:Female
Location:Tennessee
Vaccinated:2008-07-23
Onset:2008-07-23
Submitted:2008-08-01
Entered:2008-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER 1740U 8/10 / 2 RA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Fall, 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:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: After receiving Gardasil patient fainted and fell to floor. Patient''s vital signs were taken and monitored for about 30 mins after episode.

New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=321093&WAYBACKHISTORY=ON


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