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This is VAERS ID 280163

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 280163
Age:11.0
Gender:Female
Location:Unknown
Vaccinated:2007-05-01
Onset:2007-05-04
Submitted:2007-05-31
Entered:2007-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / UN

Administered by: Other      Purchased by: Unknown
Symptoms: Anaphylactic reaction, Cardiac arrest, Death

Life Threatening? Yes
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Information has been received from a nurse practitioner who heard from an emergency room (ER) nurse that an 11 year old female was vaccinated /"within in the past month/" in approximately May 2007 with a first dose of Gardasil. Subsequently, 3 days after"vaccination the patient presented to an ER. She experienced cardiac arrest, required lung bypass (ECMO) and /"may not have expired./" It was also reported by the same nurse that the physician from the hospital said that /"the death was due to an anaphylac


Changed on 12/8/2009

VAERS ID: 280163 Before After
Age:11.0
Gender:Female
Location:Unknown
Vaccinated:2007-05-01
Onset:2007-05-04
Submitted:2007-05-31
Entered:2007-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / UN

Administered by: Other      Purchased by: Unknown Other
Symptoms: Anaphylactic reaction, Cardiac arrest, Death

Life Threatening? Yes
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data:
CDC 'Split Type': (blank) WAES0705USA04839

Write-up:Information has been received from a nurse practitioner who heard from an emergency room (ER) nurse that an 11 year old female was vaccinated /"within "within in the past month/" month" in approximately May 2007 with a first dose of Gardasil. Subsequently, 3 days after"vaccination after vaccination the patient presented to an ER. She experienced cardiac arrest, required lung bypass (ECMO) and /"may "may not have expired./" expired." It was also reported by the same nurse that the physician from the hospital said that /"the "the death was due to an anaphylac anaphylactic reaction to Gardasil." The anaphylactic reaction and cardiac arrest were considered to be life threatening by the reporter. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=280163&WAYBACKHISTORY=ON


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