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This is VAERS ID 384205

History of Changes from the VAERS Wayback Machine

First Appeared on 4/7/2010

VAERS ID: 384205
VAERS Form:
Age:13.0
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2010-04-02
Entered:2010-04-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Death, Headache, Vaccine positive rechallenge

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES1003USA04772

Write-up: Information has been received from a nurse practitioner concerning a 13 year old female patient who on unspecified dates was vaccinated with three doses of GARDASIL at the nurse practitioner''s previous practice. The patient experienced headache after getting first and second dose of GARDASIL. The patient sought unspecified medical attention. After the third dose of GARDASIL the patient experienced headache and died on the same day. The cause of death was not reported. Additional information has been requested.


Changed on 1/4/2011

VAERS ID: 384205 Before After
VAERS Form:
Age:13.0
Sex:Female
Location:Unknown Foreign
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2010-04-02
Entered:2010-04-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Death, Headache, Vaccine positive rechallenge

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES1003USA04772

Write-up: Information has been received from a nurse practitioner concerning a 13 year old female patient who on unspecified dates was vaccinated with three doses of GARDASIL at the nurse practitioner''s previous practice. The patient experienced headache after getting first and second dose of GARDASIL. The patient sought unspecified medical attention. After the third dose of GARDASIL the patient experienced headache and died on the same day. The cause of death was not reported. Additional information has been requested.


Changed on 6/14/2014

VAERS ID: 384205 Before After
VAERS Form:
Age:13.0
Sex:Female
Location:Foreign
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2010-04-02
Entered:2010-04-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Death, Headache, Vaccine positive rechallenge

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES1003USA04772

Write-up: Information has been received from a nurse practitioner concerning a 13 year old female patient who on unspecified dates was vaccinated with three doses of GARDASIL at the nurse practitioner''s previous practice. The patient experienced headache after getting first and second dose of GARDASIL. The patient sought unspecified medical attention. After the third dose of GARDASIL the patient experienced headache and died on the same day. The cause of death was not reported. Additional information has been requested.


Changed on 4/14/2017

VAERS ID: 384205 Before After
VAERS Form:
Age:13.0
Sex:Female
Location:Foreign
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2010-04-02
Entered:2010-04-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Death, Headache, Vaccine positive rechallenge

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES1003USA04772

Write-up: Information has been received from a nurse practitioner concerning a 13 year old female patient who on unspecified dates was vaccinated with three doses of GARDASIL at the nurse practitioner''s previous practice. The patient experienced headache after getting first and second dose of GARDASIL. The patient sought unspecified medical attention. After the third dose of GARDASIL the patient experienced headache and died on the same day. The cause of death was not reported. Additional information has been requested.


Changed on 9/14/2017

VAERS ID: 384205 Before After
VAERS Form:(blank) 1
Age:13.0
Sex:Female
Location:Foreign
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2010-04-02
Entered:2010-04-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Death, Headache, Vaccine positive rechallenge

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES1003USA04772

Write-up: Information has been received from a nurse practitioner concerning a 13 year old female patient who on unspecified dates was vaccinated with three doses of GARDASIL at the nurse practitioner''s previous practice. The patient experienced headache after getting first and second dose of GARDASIL. The patient sought unspecified medical attention. After the third dose of GARDASIL the patient experienced headache and died on the same day. The cause of death was not reported. Additional information has been requested.


Changed on 2/14/2018

VAERS ID: 384205 Before After
VAERS Form:1
Age:13.0
Sex:Female
Location:Foreign
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2010-04-02
Entered:2010-04-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Death, Headache, Vaccine positive rechallenge

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES1003USA04772

Write-up: Information has been received from a nurse practitioner concerning a 13 year old female patient who on unspecified dates was vaccinated with three doses of GARDASIL at the nurse practitioner''s previous practice. The patient experienced headache after getting first and second dose of GARDASIL. The patient sought unspecified medical attention. After the third dose of GARDASIL the patient experienced headache and died on the same day. The cause of death was not reported. Additional information has been requested.


Changed on 6/14/2018

VAERS ID: 384205 Before After
VAERS Form:1
Age:13.0
Sex:Female
Location:Foreign
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2010-04-02
Entered:2010-04-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Death, Headache, Vaccine positive rechallenge

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES1003USA04772

Write-up: Information has been received from a nurse practitioner concerning a 13 year old female patient who on unspecified dates was vaccinated with three doses of GARDASIL at the nurse practitioner''s previous practice. The patient experienced headache after getting first and second dose of GARDASIL. The patient sought unspecified medical attention. After the third dose of GARDASIL the patient experienced headache and died on the same day. The cause of death was not reported. Additional information has been requested.


Changed on 8/14/2018

VAERS ID: 384205 Before After
VAERS Form:1
Age:13.0
Sex:Female
Location:Foreign
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2010-04-02
Entered:2010-04-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Death, Headache, Vaccine positive rechallenge

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES1003USA04772

Write-up: Information has been received from a nurse practitioner concerning a 13 year old female patient who on unspecified dates was vaccinated with three doses of GARDASIL at the nurse practitioner''s previous practice. The patient experienced headache after getting first and second dose of GARDASIL. The patient sought unspecified medical attention. After the third dose of GARDASIL the patient experienced headache and died on the same day. The cause of death was not reported. Additional information has been requested.


Changed on 9/14/2018

VAERS ID: 384205 Before After
VAERS Form:1
Age:13.0
Sex:Female
Location:Foreign
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2010-04-02
Entered:2010-04-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Death, Headache, Vaccine positive rechallenge

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES1003USA04772

Write-up: Information has been received from a nurse practitioner concerning a 13 year old female patient who on unspecified dates was vaccinated with three doses of GARDASIL at the nurse practitioner''s previous practice. The patient experienced headache after getting first and second dose of GARDASIL. The patient sought unspecified medical attention. After the third dose of GARDASIL the patient experienced headache and died on the same day. The cause of death was not reported. Additional information has been requested.


Changed on 10/14/2018

VAERS ID: 384205 Before After
VAERS Form:1
Age:13.0
Sex:Female
Location:Foreign
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2010-04-02
Entered:2010-04-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Death, Headache, Vaccine positive rechallenge

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES1003USA04772

Write-up: Information has been received from a nurse practitioner concerning a 13 year old female patient who on unspecified dates was vaccinated with three doses of GARDASIL at the nurse practitioner''s previous practice. The patient experienced headache after getting first and second dose of GARDASIL. The patient sought unspecified medical attention. After the third dose of GARDASIL the patient experienced headache and died on the same day. The cause of death was not reported. Additional information has been requested.

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=384205&WAYBACKHISTORY=ON


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