National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 424381

History of Changes from the VAERS Wayback Machine

First Appeared on 6/11/2011

VAERS ID: 424381
VAERS Form:
Age:
Sex:Female
Location:Foreign
Vaccinated:2011-02-15
Onset:2011-04-03
Submitted:2011-05-31
Entered:2011-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1016Z / 2 UN / UN

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal distension, Abdominal pain, Death

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:2011-04-07
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES1105USA03118

Write-up: Information has been received from a physician as part of the GARDASIL Access Program concerning a female who entered a HPV vaccine pilot project. On 15-FEB-2011 was vaccinated with 3rd dose of GARDASIL (lot # 666987/1016Z). The patient was admitted to hospital with abdominal pain and distension on 03-APR-2011. The patient died on hospital on 07-APR-2011. The cause of death was abdominal pain and abdominal distension. The reporting physician felt that abdominal pain (grade 5) and abdominal distension (grade 5) were not related to GARDASIL. Abdominal pain (grade 5) and abdominal distension (grade 5) were considered to be immediately life-threatening. A lot check has been initiated. Additional information has been requested.


Changed on 6/14/2014

VAERS ID: 424381 Before After
VAERS Form:
Age:
Sex:Female
Location:Foreign
Vaccinated:2011-02-15
Onset:2011-04-03
Submitted:2011-05-31
Entered:2011-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1016Z / 2 UN / UN

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal distension, Abdominal pain, Death

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:2011-04-07
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES1105USA03118

Write-up: Information has been received from a physician as part of the GARDASIL Access Program concerning a female who entered a HPV vaccine pilot project. On 15-FEB-2011 was vaccinated with 3rd dose of GARDASIL (lot # 666987/1016Z). The patient was admitted to hospital with abdominal pain and distension on 03-APR-2011. The patient died on hospital on 07-APR-2011. The cause of death was abdominal pain and abdominal distension. The reporting physician felt that abdominal pain (grade 5) and abdominal distension (grade 5) were not related to GARDASIL. Abdominal pain (grade 5) and abdominal distension (grade 5) were considered to be immediately life-threatening. A lot check has been initiated. Additional information has been requested.


Changed on 4/14/2017

VAERS ID: 424381 Before After
VAERS Form:
Age:
Sex:Female
Location:Foreign
Vaccinated:2011-02-15
Onset:2011-04-03
Submitted:2011-05-31
Entered:2011-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1016Z / 2 UN / UN

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal distension, Abdominal pain, Death

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:2011-04-07
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES1105USA03118

Write-up: Information has been received from a physician as part of the GARDASIL Access Program concerning a female who entered a HPV vaccine pilot project. On 15-FEB-2011 was vaccinated with 3rd dose of GARDASIL (lot # 666987/1016Z). The patient was admitted to hospital with abdominal pain and distension on 03-APR-2011. The patient died on hospital on 07-APR-2011. The cause of death was abdominal pain and abdominal distension. The reporting physician felt that abdominal pain (grade 5) and abdominal distension (grade 5) were not related to GARDASIL. Abdominal pain (grade 5) and abdominal distension (grade 5) were considered to be immediately life-threatening. A lot check has been initiated. Additional information has been requested.


Changed on 9/14/2017

VAERS ID: 424381 Before After
VAERS Form:(blank) 1
Age:
Sex:Female
Location:Foreign
Vaccinated:2011-02-15
Onset:2011-04-03
Submitted:2011-05-31
Entered:2011-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1016Z / 2 3 UN / UN

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal distension, Abdominal pain, Death

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:2011-04-07
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES1105USA03118

Write-up: Information has been received from a physician as part of the GARDASIL Access Program concerning a female who entered a HPV vaccine pilot project. On 15-FEB-2011 was vaccinated with 3rd dose of GARDASIL (lot # 666987/1016Z). The patient was admitted to hospital with abdominal pain and distension on 03-APR-2011. The patient died on hospital on 07-APR-2011. The cause of death was abdominal pain and abdominal distension. The reporting physician felt that abdominal pain (grade 5) and abdominal distension (grade 5) were not related to GARDASIL. Abdominal pain (grade 5) and abdominal distension (grade 5) were considered to be immediately life-threatening. A lot check has been initiated. Additional information has been requested.


Changed on 2/14/2018

VAERS ID: 424381 Before After
VAERS Form:1
Age:
Sex:Female
Location:Foreign
Vaccinated:2011-02-15
Onset:2011-04-03
Submitted:2011-05-31
Entered:2011-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1016Z / 3 UN / UN

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal distension, Abdominal pain, Death

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:2011-04-07
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES1105USA03118

Write-up: Information has been received from a physician as part of the GARDASIL Access Program concerning a female who entered a HPV vaccine pilot project. On 15-FEB-2011 was vaccinated with 3rd dose of GARDASIL (lot # 666987/1016Z). The patient was admitted to hospital with abdominal pain and distension on 03-APR-2011. The patient died on hospital on 07-APR-2011. The cause of death was abdominal pain and abdominal distension. The reporting physician felt that abdominal pain (grade 5) and abdominal distension (grade 5) were not related to GARDASIL. Abdominal pain (grade 5) and abdominal distension (grade 5) were considered to be immediately life-threatening. A lot check has been initiated. Additional information has been requested.


Changed on 6/14/2018

VAERS ID: 424381 Before After
VAERS Form:1
Age:
Sex:Female
Location:Foreign
Vaccinated:2011-02-15
Onset:2011-04-03
Submitted:2011-05-31
Entered:2011-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1016Z / 3 UN / UN

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal distension, Abdominal pain, Death

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:2011-04-07
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES1105USA03118

Write-up: Information has been received from a physician as part of the GARDASIL Access Program concerning a female who entered a HPV vaccine pilot project. On 15-FEB-2011 was vaccinated with 3rd dose of GARDASIL (lot # 666987/1016Z). The patient was admitted to hospital with abdominal pain and distension on 03-APR-2011. The patient died on hospital on 07-APR-2011. The cause of death was abdominal pain and abdominal distension. The reporting physician felt that abdominal pain (grade 5) and abdominal distension (grade 5) were not related to GARDASIL. Abdominal pain (grade 5) and abdominal distension (grade 5) were considered to be immediately life-threatening. A lot check has been initiated. Additional information has been requested.


Changed on 8/14/2018

VAERS ID: 424381 Before After
VAERS Form:1
Age:
Sex:Female
Location:Foreign
Vaccinated:2011-02-15
Onset:2011-04-03
Submitted:2011-05-31
Entered:2011-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1016Z / 3 UN / UN

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal distension, Abdominal pain, Death

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:2011-04-07
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES1105USA03118

Write-up: Information has been received from a physician as part of the GARDASIL Access Program concerning a female who entered a HPV vaccine pilot project. On 15-FEB-2011 was vaccinated with 3rd dose of GARDASIL (lot # 666987/1016Z). The patient was admitted to hospital with abdominal pain and distension on 03-APR-2011. The patient died on hospital on 07-APR-2011. The cause of death was abdominal pain and abdominal distension. The reporting physician felt that abdominal pain (grade 5) and abdominal distension (grade 5) were not related to GARDASIL. Abdominal pain (grade 5) and abdominal distension (grade 5) were considered to be immediately life-threatening. A lot check has been initiated. Additional information has been requested.


Changed on 9/14/2018

VAERS ID: 424381 Before After
VAERS Form:1
Age:
Sex:Female
Location:Foreign
Vaccinated:2011-02-15
Onset:2011-04-03
Submitted:2011-05-31
Entered:2011-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1016Z / 3 UN / UN

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal distension, Abdominal pain, Death

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:2011-04-07
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES1105USA03118

Write-up: Information has been received from a physician as part of the GARDASIL Access Program concerning a female who entered a HPV vaccine pilot project. On 15-FEB-2011 was vaccinated with 3rd dose of GARDASIL (lot # 666987/1016Z). The patient was admitted to hospital with abdominal pain and distension on 03-APR-2011. The patient died on hospital on 07-APR-2011. The cause of death was abdominal pain and abdominal distension. The reporting physician felt that abdominal pain (grade 5) and abdominal distension (grade 5) were not related to GARDASIL. Abdominal pain (grade 5) and abdominal distension (grade 5) were considered to be immediately life-threatening. A lot check has been initiated. Additional information has been requested.


Changed on 10/14/2018

VAERS ID: 424381 Before After
VAERS Form:1
Age:
Sex:Female
Location:Foreign
Vaccinated:2011-02-15
Onset:2011-04-03
Submitted:2011-05-31
Entered:2011-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1016Z / 3 UN / UN

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal distension, Abdominal pain, Death

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:2011-04-07
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES1105USA03118

Write-up: Information has been received from a physician as part of the GARDASIL Access Program concerning a female who entered a HPV vaccine pilot project. On 15-FEB-2011 was vaccinated with 3rd dose of GARDASIL (lot # 666987/1016Z). The patient was admitted to hospital with abdominal pain and distension on 03-APR-2011. The patient died on hospital on 07-APR-2011. The cause of death was abdominal pain and abdominal distension. The reporting physician felt that abdominal pain (grade 5) and abdominal distension (grade 5) were not related to GARDASIL. Abdominal pain (grade 5) and abdominal distension (grade 5) were considered to be immediately life-threatening. A lot check has been initiated. Additional information has been requested.

New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=424381&WAYBACKHISTORY=ON


Copyright © 2020 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166