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This is VAERS ID 423397

History of Changes from the VAERS Wayback Machine

First Appeared on 6/11/2011

VAERS ID: 423397
Age:12.0
Gender:Female
Location:Foreign
Vaccinated:2011-04-11
Onset:2011-04-11
Submitted:2011-05-19
Entered:2011-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. NJ51180 / 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Dizziness, Headache, Nausea, Somnolence

Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Familial risk factor
Preexisting Conditions: Vomiting; Tremor; Syncope; Vomiting; Prostration; Syncope; Tremor; Prostration
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES1105USA02444

Write-up:Case received from Health Authorities on 10-MAY-2011 under the reference number L201102-356. Case medically confirmed. A 12-year-old female patient had received the second dose of GARDASIL (batch n.NM14120, lot n. NJ51180 in left deltoid area) via intramuscular route at 12:00 on 11-APR-2011 and in the same day, at 17:00 the patient experienced nausea, dizziness, headache and somnolence that resolved on 12-APR-2011. No relevant clinical history known. Family history: uncle with epilepsy. The patient had previous history of AE to the vaccine against the pandemic flu (manufacturer unknown) on 21-DEC-2009 with vomiting, tremor, fainting and prostration. The patient had also received H1N1 like virus on 21-DEC-2010 via intramuscular route for prophylaxis. The patient had received the first dose of GARDASIL (batch n.NM14120, lot n. NJ51180 in left deltoid area) via intramuscular route on 02-FEB-2011 and post-vaccination the patient presented with lipothymy during seconds, tremor during minutes and vomiting (food content) without other manifestations. The AEs also included prostration during about 1 hour (see case E2011-01255 (WAES #1102USA03388). The patient had fully recovered. Case is closed. the events were considered to be disabling. Other business partner numbers include E2011-02916. No further information is available.


Changed on 6/14/2014

VAERS ID: 423397 Before After
Age:12.0
Gender:Female
Location:Foreign
Vaccinated:2011-04-11
Onset:2011-04-11
Submitted:2011-05-19
Entered:2011-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. NJ51180 / 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Dizziness, Headache, Nausea, Somnolence

Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Familial risk factor
Preexisting Conditions: Vomiting; Tremor; Syncope; Vomiting; Prostration; Syncope; Tremor; Prostration
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES1105USA02444

Write-up:Case received from Health Authorities on 10-MAY-2011 under the reference number L201102-356. Case medically confirmed. A 12-year-old female patient had received the second dose of GARDASIL (batch n.NM14120, lot n. NJ51180 in left deltoid area) via intramuscular route at 12:00 on 11-APR-2011 and in the same day, at 17:00 the patient experienced nausea, dizziness, headache and somnolence that resolved on 12-APR-2011. No relevant clinical history known. Family history: uncle with epilepsy. The patient had previous history of AE to the vaccine against the pandemic flu (manufacturer unknown) on 21-DEC-2009 with vomiting, tremor, fainting and prostration. The patient had also received H1N1 like virus on 21-DEC-2010 via intramuscular route for prophylaxis. The patient had received the first dose of GARDASIL (batch n.NM14120, lot n. NJ51180 in left deltoid area) via intramuscular route on 02-FEB-2011 and post-vaccination the patient presented with lipothymy during seconds, tremor during minutes and vomiting (food content) without other manifestations. The AEs also included prostration during about 1 hour (see case E2011-01255 (WAES #1102USA03388). The patient had fully recovered. Case is closed. the events were considered to be disabling. Other business partner numbers include E2011-02916. No further information is available.


Changed on 4/14/2017

VAERS ID: 423397 Before After
Age:12.0
Gender:Female
Location:Foreign
Vaccinated:2011-04-11
Onset:2011-04-11
Submitted:2011-05-19
Entered:2011-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. NJ51180 / 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Dizziness, Headache, Nausea, Somnolence

Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Familial risk factor
Preexisting Conditions: Vomiting; Tremor; Syncope; Vomiting; Prostration; Syncope; Tremor; Prostration
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES1105USA02444

Write-up:Case received from Health Authorities on 10-MAY-2011 under the reference number L201102-356. Case medically confirmed. A 12-year-old female patient had received the second dose of GARDASIL (batch n.NM14120, lot n. NJ51180 in left deltoid area) via intramuscular route at 12:00 on 11-APR-2011 and in the same day, at 17:00 the patient experienced nausea, dizziness, headache and somnolence that resolved on 12-APR-2011. No relevant clinical history known. Family history: uncle with epilepsy. The patient had previous history of AE to the vaccine against the pandemic flu (manufacturer unknown) on 21-DEC-2009 with vomiting, tremor, fainting and prostration. The patient had also received H1N1 like virus on 21-DEC-2010 via intramuscular route for prophylaxis. The patient had received the first dose of GARDASIL (batch n.NM14120, lot n. NJ51180 in left deltoid area) via intramuscular route on 02-FEB-2011 and post-vaccination the patient presented with lipothymy during seconds, tremor during minutes and vomiting (food content) without other manifestations. The AEs also included prostration during about 1 hour (see case E2011-01255 (WAES #1102USA03388). The patient had fully recovered. Case is closed. the events were considered to be disabling. Other business partner numbers include E2011-02916. No further information is available.


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