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This is VAERS ID 488261

History of Changes from the VAERS Wayback Machine

First Appeared on 8/12/2013

VAERS ID: 488261
VAERS Form:
Age:17.0
Sex:Female
Location:Foreign
Vaccinated:2013-03-09
Onset:2013-03-09
Submitted:2013-04-02
Entered:2013-04-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. NK38610 / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain upper, Inappropriate schedule of drug administration, Injection site pain, Loss of consciousness, Mydriasis, Syncope, Mental disorder, Expired drug administered

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: No other medications
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES1303FRA014449

Write-up: Case of misuse received from a physician and a pharmacist on 11-Mar-2013. Case medically confirmed. A 17-year-old female patient received the second dose of GARDASIL (batch number NP39110, lot number NK38610) on 09-Mar-2013. The patient experienced pain during the injection. After performing vaccination the physician realized that the dose had expired since Apr-2012. The physician informed the patient who then experienced syncope with loss of consciousness, mydriasis and epigastric clonus. The syncope lasted only a few seconds or minutes. The patient recovered. According to the physician these events were likely to be psychological. The patient had received the first dose of GARDASIL (batch number not reported in July 2011. It is noteworthy the timeframe between the first dose and the second one was too long.


Changed on 9/14/2017

VAERS ID: 488261 Before After
VAERS Form:(blank) 1
Age:17.0
Sex:Female
Location:Foreign
Vaccinated:2013-03-09
Onset:2013-03-09
Submitted:2013-04-02
Entered:2013-04-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. NK38610 / 1 2 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain upper, Inappropriate schedule of drug administration, Injection site pain, Loss of consciousness, Mydriasis, Syncope, Mental disorder, Expired drug administered

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: No other medications
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES1303FRA014449

Write-up: Case of misuse received from a physician and a pharmacist on 11-Mar-2013. Case medically confirmed. A 17-year-old female patient received the second dose of GARDASIL (batch number NP39110, lot number NK38610) on 09-Mar-2013. The patient experienced pain during the injection. After performing vaccination the physician realized that the dose had expired since Apr-2012. The physician informed the patient who then experienced syncope with loss of consciousness, mydriasis and epigastric clonus. The syncope lasted only a few seconds or minutes. The patient recovered. According to the physician these events were likely to be psychological. The patient had received the first dose of GARDASIL (batch number not reported in July 2011. It is noteworthy the timeframe between the first dose and the second one was too long.


Changed on 2/14/2018

VAERS ID: 488261 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:Foreign
Vaccinated:2013-03-09
Onset:2013-03-09
Submitted:2013-04-02
Entered:2013-04-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. NK38610 / 2 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain upper, Inappropriate schedule of drug administration, Injection site pain, Loss of consciousness, Mydriasis, Syncope, Mental disorder, Expired drug administered

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: No other medications
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES1303FRA014449

Write-up: Case of misuse received from a physician and a pharmacist on 11-Mar-2013. Case medically confirmed. A 17-year-old female patient received the second dose of GARDASIL (batch number NP39110, lot number NK38610) on 09-Mar-2013. The patient experienced pain during the injection. After performing vaccination the physician realized that the dose had expired since Apr-2012. The physician informed the patient who then experienced syncope with loss of consciousness, mydriasis and epigastric clonus. The syncope lasted only a few seconds or minutes. The patient recovered. According to the physician these events were likely to be psychological. The patient had received the first dose of GARDASIL (batch number not reported in July 2011. It is noteworthy the timeframe between the first dose and the second one was too long.


Changed on 6/14/2018

VAERS ID: 488261 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:Foreign
Vaccinated:2013-03-09
Onset:2013-03-09
Submitted:2013-04-02
Entered:2013-04-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. NK38610 / 2 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain upper, Inappropriate schedule of drug administration, Injection site pain, Loss of consciousness, Mydriasis, Syncope, Mental disorder, Expired drug administered

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: No other medications
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES1303FRA014449

Write-up: Case of misuse received from a physician and a pharmacist on 11-Mar-2013. Case medically confirmed. A 17-year-old female patient received the second dose of GARDASIL (batch number NP39110, lot number NK38610) on 09-Mar-2013. The patient experienced pain during the injection. After performing vaccination the physician realized that the dose had expired since Apr-2012. The physician informed the patient who then experienced syncope with loss of consciousness, mydriasis and epigastric clonus. The syncope lasted only a few seconds or minutes. The patient recovered. According to the physician these events were likely to be psychological. The patient had received the first dose of GARDASIL (batch number not reported in July 2011. It is noteworthy the timeframe between the first dose and the second one was too long.


Changed on 8/14/2018

VAERS ID: 488261 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:Foreign
Vaccinated:2013-03-09
Onset:2013-03-09
Submitted:2013-04-02
Entered:2013-04-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. NK38610 / 2 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain upper, Inappropriate schedule of drug administration, Injection site pain, Loss of consciousness, Mydriasis, Syncope, Mental disorder, Expired drug administered

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: No other medications
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES1303FRA014449

Write-up: Case of misuse received from a physician and a pharmacist on 11-Mar-2013. Case medically confirmed. A 17-year-old female patient received the second dose of GARDASIL (batch number NP39110, lot number NK38610) on 09-Mar-2013. The patient experienced pain during the injection. After performing vaccination the physician realized that the dose had expired since Apr-2012. The physician informed the patient who then experienced syncope with loss of consciousness, mydriasis and epigastric clonus. The syncope lasted only a few seconds or minutes. The patient recovered. According to the physician these events were likely to be psychological. The patient had received the first dose of GARDASIL (batch number not reported in July 2011. It is noteworthy the timeframe between the first dose and the second one was too long.


Changed on 9/14/2018

VAERS ID: 488261 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:Foreign
Vaccinated:2013-03-09
Onset:2013-03-09
Submitted:2013-04-02
Entered:2013-04-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. NK38610 / 2 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain upper, Inappropriate schedule of drug administration, Injection site pain, Loss of consciousness, Mydriasis, Syncope, Mental disorder, Expired drug administered

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: No other medications
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES1303FRA014449

Write-up: Case of misuse received from a physician and a pharmacist on 11-Mar-2013. Case medically confirmed. A 17-year-old female patient received the second dose of GARDASIL (batch number NP39110, lot number NK38610) on 09-Mar-2013. The patient experienced pain during the injection. After performing vaccination the physician realized that the dose had expired since Apr-2012. The physician informed the patient who then experienced syncope with loss of consciousness, mydriasis and epigastric clonus. The syncope lasted only a few seconds or minutes. The patient recovered. According to the physician these events were likely to be psychological. The patient had received the first dose of GARDASIL (batch number not reported in July 2011. It is noteworthy the timeframe between the first dose and the second one was too long.


Changed on 10/14/2018

VAERS ID: 488261 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:Foreign
Vaccinated:2013-03-09
Onset:2013-03-09
Submitted:2013-04-02
Entered:2013-04-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. NK38610 / 2 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain upper, Inappropriate schedule of drug administration, Injection site pain, Loss of consciousness, Mydriasis, Syncope, Mental disorder, Expired drug administered

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: No other medications
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES1303FRA014449

Write-up: Case of misuse received from a physician and a pharmacist on 11-Mar-2013. Case medically confirmed. A 17-year-old female patient received the second dose of GARDASIL (batch number NP39110, lot number NK38610) on 09-Mar-2013. The patient experienced pain during the injection. After performing vaccination the physician realized that the dose had expired since Apr-2012. The physician informed the patient who then experienced syncope with loss of consciousness, mydriasis and epigastric clonus. The syncope lasted only a few seconds or minutes. The patient recovered. According to the physician these events were likely to be psychological. The patient had received the first dose of GARDASIL (batch number not reported in July 2011. It is noteworthy the timeframe between the first dose and the second one was too long.

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=488261&WAYBACKHISTORY=ON


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