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This is VAERS ID 336766

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2008

VAERS ID: 336766
VAERS Form:
Age:15.0
Gender:Female
Location:California
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2008-12-12
Entered:2008-12-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Other      Purchased by: Unknown
Symptoms: Head injury, Syncope, Nodule

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: Therapy unspecified
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type':

Write-up: Information has been received from a physician concerning a 15 year old female who was vaccinated with the second dose of GARDASIL. Concomitant medication included other unspecified vaccines. About 2 months ago, in approximately September 2008, the patien"t experienced fainted, hit the back of her head and got a lump. On an unspecified date in 2008, the patient recovered. Additional information has been requested.


Changed on 12/8/2009

VAERS ID: 336766 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:California
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2008-12-12
Entered:2008-12-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Other      Purchased by: Unknown Other
Symptoms: Head injury, Syncope, Nodule

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: Therapy unspecified
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': (blank) WAES0811USA00691

Write-up: Information has been received from a physician concerning a 15 year old female who was vaccinated with the second dose of GARDASIL. Concomitant medication included other unspecified vaccines. About 2 months ago, in approximately September 2008, the patien"t patient experienced fainted, hit the back of her head and got a lump. On an unspecified date in 2008, the patient recovered. Additional information has been requested.


Changed on 9/14/2017

VAERS ID: 336766 Before After
VAERS Form:(blank) 1
Age:15.0
Gender:Female
Location:California
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2008-12-12
Entered:2008-12-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. - / 1 2 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Head injury, Syncope, Nodule

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: Therapy unspecified
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0811USA00691

Write-up: Information has been received from a physician concerning a 15 year old female who was vaccinated with the second dose of GARDASIL. Concomitant medication included other unspecified vaccines. About 2 months ago, in approximately September 2008, the patient experienced fainted, hit the back of her head and got a lump. On an unspecified date in 2008, the patient recovered. Additional information has been requested.


Changed on 2/14/2018

VAERS ID: 336766 Before After
VAERS Form:1
Age:15.0
Gender:Female
Location:California
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2008-12-12
Entered:2008-12-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. - / 2 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Head injury, Syncope, Nodule

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: Therapy unspecified
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0811USA00691

Write-up: Information has been received from a physician concerning a 15 year old female who was vaccinated with the second dose of GARDASIL. Concomitant medication included other unspecified vaccines. About 2 months ago, in approximately September 2008, the patient experienced fainted, hit the back of her head and got a lump. On an unspecified date in 2008, the patient recovered. Additional information has been requested.


Changed on 6/14/2018

VAERS ID: 336766 Before After
VAERS Form:1
Age:15.0
Gender:Female
Location:California
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2008-12-12
Entered:2008-12-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. - / 2 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Head injury, Syncope, Nodule

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: Therapy unspecified
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0811USA00691

Write-up: Information has been received from a physician concerning a 15 year old female who was vaccinated with the second dose of GARDASIL. Concomitant medication included other unspecified vaccines. About 2 months ago, in approximately September 2008, the patient experienced fainted, hit the back of her head and got a lump. On an unspecified date in 2008, the patient recovered. Additional information has been requested.

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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=336766&WAYBACKHISTORY=ON


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