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This is VAERS ID 460438

History of Changes from the VAERS Wayback Machine

First Appeared on 8/13/2012

VAERS ID: 460438
VAERS Form:
Age:17.0
Sex:Male
Location:Texas
Vaccinated:2012-07-26
Onset:2012-07-26
Submitted:2012-07-27
Entered:2012-07-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0022AE / 0 LA / SYR

Administered by: Public      Purchased by: Public
Symptoms: Asthenia, Feeling abnormal, Pallor

Life Threatening? Yes
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: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt. received vaccine at approximately 1:10pm on 7-26-12. Pt. reacted to the vaccine 5 minutes later and was feeling dazed, pale, weak. Treatment with epinephrine .2mL. Pt. recovered 20 minutes after injection of epinephrine. Site was the deltoid of the left arm.


Changed on 9/14/2017

VAERS ID: 460438 Before After
VAERS Form:(blank) 1
Age:17.0
Sex:Male
Location:Texas
Vaccinated:2012-07-26
Onset:2012-07-26
Submitted:2012-07-27
Entered:2012-07-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0022AE / 0 1 LA / SYR

Administered by: Public      Purchased by: Public
Symptoms: Asthenia, Feeling abnormal, Pallor

Life Threatening? Yes
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: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt. received vaccine at approximately 1:10pm on 7-26-12. Pt. reacted to the vaccine 5 minutes later and was feeling dazed, pale, weak. Treatment with epinephrine .2mL. Pt. recovered 20 minutes after injection of epinephrine. Site was the deltoid of the left arm.


Changed on 2/14/2018

VAERS ID: 460438 Before After
VAERS Form:1
Age:17.0
Sex:Male
Location:Texas
Vaccinated:2012-07-26
Onset:2012-07-26
Submitted:2012-07-27
Entered:2012-07-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0022AE / 1 LA / SYR

Administered by: Public      Purchased by: Public
Symptoms: Asthenia, Feeling abnormal, Pallor

Life Threatening? Yes
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: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt. received vaccine at approximately 1:10pm on 7-26-12. Pt. reacted to the vaccine 5 minutes later and was feeling dazed, pale, weak. Treatment with epinephrine .2mL. Pt. recovered 20 minutes after injection of epinephrine. Site was the deltoid of the left arm.


Changed on 6/14/2018

VAERS ID: 460438 Before After
VAERS Form:1
Age:17.0
Sex:Male
Location:Texas
Vaccinated:2012-07-26
Onset:2012-07-26
Submitted:2012-07-27
Entered:2012-07-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0022AE / 1 LA / SYR

Administered by: Public      Purchased by: Public
Symptoms: Asthenia, Feeling abnormal, Pallor

Life Threatening? Yes
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: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt. received vaccine at approximately 1:10pm on 7-26-12. Pt. reacted to the vaccine 5 minutes later and was feeling dazed, pale, weak. Treatment with epinephrine .2mL. Pt. recovered 20 minutes after injection of epinephrine. Site was the deltoid of the left arm.


Changed on 8/14/2018

VAERS ID: 460438 Before After
VAERS Form:1
Age:17.0
Sex:Male
Location:Texas
Vaccinated:2012-07-26
Onset:2012-07-26
Submitted:2012-07-27
Entered:2012-07-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0022AE / 1 LA / SYR

Administered by: Public      Purchased by: Public
Symptoms: Asthenia, Feeling abnormal, Pallor

Life Threatening? Yes
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: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt. received vaccine at approximately 1:10pm on 7-26-12. Pt. reacted to the vaccine 5 minutes later and was feeling dazed, pale, weak. Treatment with epinephrine .2mL. Pt. recovered 20 minutes after injection of epinephrine. Site was the deltoid of the left arm.


Changed on 9/14/2018

VAERS ID: 460438 Before After
VAERS Form:1
Age:17.0
Sex:Male
Location:Texas
Vaccinated:2012-07-26
Onset:2012-07-26
Submitted:2012-07-27
Entered:2012-07-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0022AE / 1 LA / SYR

Administered by: Public      Purchased by: Public
Symptoms: Asthenia, Feeling abnormal, Pallor

Life Threatening? Yes
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: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt. received vaccine at approximately 1:10pm on 7-26-12. Pt. reacted to the vaccine 5 minutes later and was feeling dazed, pale, weak. Treatment with epinephrine .2mL. Pt. recovered 20 minutes after injection of epinephrine. Site was the deltoid of the left arm.


Changed on 10/14/2018

VAERS ID: 460438 Before After
VAERS Form:1
Age:17.0
Sex:Male
Location:Texas
Vaccinated:2012-07-26
Onset:2012-07-26
Submitted:2012-07-27
Entered:2012-07-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0022AE / 1 LA / SYR

Administered by: Public      Purchased by: Public
Symptoms: Asthenia, Feeling abnormal, Pallor

Life Threatening? Yes
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: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt. received vaccine at approximately 1:10pm on 7-26-12. Pt. reacted to the vaccine 5 minutes later and was feeling dazed, pale, weak. Treatment with epinephrine .2mL. Pt. recovered 20 minutes after injection of epinephrine. Site was the deltoid of the left arm.

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