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This is VAERS ID 437999

History of Changes from the VAERS Wayback Machine

First Appeared on 11/14/2011

VAERS ID: 437999
VAERS Form:
Age:18.0
Sex:Male
Location:Ohio
Vaccinated:2011-07-22
Onset:2011-07-27
Submitted:2011-10-12
Entered:2011-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0126AA / - UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0841AA / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Asphyxia, Completed suicide, Death, Drug screen negative, Toxicologic test normal

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-07-27
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: SEPTRA
Current Illness: Acne
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: diagnostic laboratory, ?/?/11, toxic screen indicated that there were no medications involved in the patient''s death.
CDC 'Split Type': WAES1110USA00917

Write-up: Information has been received from a physician concerning an 18 year old male patient with acne and no drug allergy or reaction who on 16-MAY-2011 was vaccinated with the first dose of GARDASIL (Lot number 668554/0306AA; Expired date: 10-MAY-2013) and a dose of VAQTA (Lot number: 670377/0126AA; Expired date: 07-DEC-2013, dose in series unknown). On 22-JUL-2011, the patient received the second dose of GARDASIL (Lot number 668262/0841AA; Expired date: 18-APR-2013). Concomitant therapy included SEPTRA. Follow up phone call from the physician was received. The physician reported that the patient had no medical history. The last time he saw the patient was on 22-JUL-2011, when the patient received his second dose of GARDASIL. The physician also reported that there was no indication from the patient that he was troubled. On 27-JUL-2011 the patient committed suicide. The cause of death was asphyxiation by hanging. The death report that the physician received was that the patient had a normal examination. The Toxic screen indicated that there were no medications involved in the patient''s death. The patient''s mother had asked the physician if GARDASIL could have caused her son to commit suicide. The physician reported to the patient''s mother that he did not feel that GARDASIL was the cause of her son''s suicide. The physician stated that he was not aware of any reported deaths by suicide that were related to GARDASIL. Lot checks have been initiated for 668554/0306AA, 668262/0841AA for GARDASIL and 670377/0126AA for VAQTA. Additional information has been requested.


Changed on 6/14/2014

VAERS ID: 437999 Before After
VAERS Form:
Age:18.0
Sex:Male
Location:Ohio
Vaccinated:2011-07-22
Onset:2011-07-27
Submitted:2011-10-12
Entered:2011-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0126AA / - UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0841AA / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Asphyxia, Completed suicide, Death, Drug screen negative, Toxicologic test normal

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-07-27
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: SEPTRA
Current Illness: Acne
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: diagnostic laboratory, ?/?/11, toxic screen indicated that there were no medications involved in the patient''s death.
CDC 'Split Type': WAES1110USA00917

Write-up: Information has been received from a physician concerning an 18 year old male patient with acne and no drug allergy or reaction who on 16-MAY-2011 was vaccinated with the first dose of GARDASIL (Lot number 668554/0306AA; Expired date: 10-MAY-2013) and a dose of VAQTA (Lot number: 670377/0126AA; Expired date: 07-DEC-2013, dose in series unknown). On 22-JUL-2011, the patient received the second dose of GARDASIL (Lot number 668262/0841AA; Expired date: 18-APR-2013). Concomitant therapy included SEPTRA. Follow up phone call from the physician was received. The physician reported that the patient had no medical history. The last time he saw the patient was on 22-JUL-2011, when the patient received his second dose of GARDASIL. The physician also reported that there was no indication from the patient that he was troubled. On 27-JUL-2011 the patient committed suicide. The cause of death was asphyxiation by hanging. The death report that the physician received was that the patient had a normal examination. The Toxic screen indicated that there were no medications involved in the patient''s death. The patient''s mother had asked the physician if GARDASIL could have caused her son to commit suicide. The physician reported to the patient''s mother that he did not feel that GARDASIL was the cause of her son''s suicide. The physician stated that he was not aware of any reported deaths by suicide that were related to GARDASIL. Lot checks have been initiated for 668554/0306AA, 668262/0841AA for GARDASIL and 670377/0126AA for VAQTA. Additional information has been requested.


Changed on 4/14/2017

VAERS ID: 437999 Before After
VAERS Form:
Age:18.0
Sex:Male
Location:Ohio
Vaccinated:2011-07-22
Onset:2011-07-27
Submitted:2011-10-12
Entered:2011-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0126AA / - UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0841AA / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Asphyxia, Completed suicide, Death, Drug screen negative, Toxicologic test normal

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-07-27
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: SEPTRA
Current Illness: Acne
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: diagnostic laboratory, ?/?/11, toxic screen indicated that there were no medications involved in the patient''s death.
CDC 'Split Type': WAES1110USA00917

Write-up: Information has been received from a physician concerning an 18 year old male patient with acne and no drug allergy or reaction who on 16-MAY-2011 was vaccinated with the first dose of GARDASIL (Lot number 668554/0306AA; Expired date: 10-MAY-2013) and a dose of VAQTA (Lot number: 670377/0126AA; Expired date: 07-DEC-2013, dose in series unknown). On 22-JUL-2011, the patient received the second dose of GARDASIL (Lot number 668262/0841AA; Expired date: 18-APR-2013). Concomitant therapy included SEPTRA. Follow up phone call from the physician was received. The physician reported that the patient had no medical history. The last time he saw the patient was on 22-JUL-2011, when the patient received his second dose of GARDASIL. The physician also reported that there was no indication from the patient that he was troubled. On 27-JUL-2011 the patient committed suicide. The cause of death was asphyxiation by hanging. The death report that the physician received was that the patient had a normal examination. The Toxic screen indicated that there were no medications involved in the patient''s death. The patient''s mother had asked the physician if GARDASIL could have caused her son to commit suicide. The physician reported to the patient''s mother that he did not feel that GARDASIL was the cause of her son''s suicide. The physician stated that he was not aware of any reported deaths by suicide that were related to GARDASIL. Lot checks have been initiated for 668554/0306AA, 668262/0841AA for GARDASIL and 670377/0126AA for VAQTA. Additional information has been requested.


Changed on 9/14/2017

VAERS ID: 437999 Before After
VAERS Form:(blank) 1
Age:18.0
Sex:Male
Location:Ohio
Vaccinated:2011-07-22
Onset:2011-07-27
Submitted:2011-10-12
Entered:2011-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0126AA / - UNK UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0841AA / 1 2 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Asphyxia, Completed suicide, Death, Drug screen negative, Toxicologic test normal

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-07-27
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: SEPTRA
Current Illness: Acne
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: diagnostic laboratory, ?/?/11, toxic screen indicated that there were no medications involved in the patient''s death.
CDC 'Split Type': WAES1110USA00917

Write-up: Information has been received from a physician concerning an 18 year old male patient with acne and no drug allergy or reaction who on 16-MAY-2011 was vaccinated with the first dose of GARDASIL (Lot number 668554/0306AA; Expired date: 10-MAY-2013) and a dose of VAQTA (Lot number: 670377/0126AA; Expired date: 07-DEC-2013, dose in series unknown). On 22-JUL-2011, the patient received the second dose of GARDASIL (Lot number 668262/0841AA; Expired date: 18-APR-2013). Concomitant therapy included SEPTRA. Follow up phone call from the physician was received. The physician reported that the patient had no medical history. The last time he saw the patient was on 22-JUL-2011, when the patient received his second dose of GARDASIL. The physician also reported that there was no indication from the patient that he was troubled. On 27-JUL-2011 the patient committed suicide. The cause of death was asphyxiation by hanging. The death report that the physician received was that the patient had a normal examination. The Toxic screen indicated that there were no medications involved in the patient''s death. The patient''s mother had asked the physician if GARDASIL could have caused her son to commit suicide. The physician reported to the patient''s mother that he did not feel that GARDASIL was the cause of her son''s suicide. The physician stated that he was not aware of any reported deaths by suicide that were related to GARDASIL. Lot checks have been initiated for 668554/0306AA, 668262/0841AA for GARDASIL and 670377/0126AA for VAQTA. Additional information has been requested.


Changed on 2/14/2018

VAERS ID: 437999 Before After
VAERS Form:1
Age:18.0
Sex:Male
Location:Ohio
Vaccinated:2011-07-22
Onset:2011-07-27
Submitted:2011-10-12
Entered:2011-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0126AA / UNK UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0841AA / 2 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Asphyxia, Completed suicide, Death, Drug screen negative, Toxicologic test normal

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-07-27
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: SEPTRA
Current Illness: Acne
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: diagnostic laboratory, ?/?/11, toxic screen indicated that there were no medications involved in the patient''s death.
CDC 'Split Type': WAES1110USA00917

Write-up: Information has been received from a physician concerning an 18 year old male patient with acne and no drug allergy or reaction who on 16-MAY-2011 was vaccinated with the first dose of GARDASIL (Lot number 668554/0306AA; Expired date: 10-MAY-2013) and a dose of VAQTA (Lot number: 670377/0126AA; Expired date: 07-DEC-2013, dose in series unknown). On 22-JUL-2011, the patient received the second dose of GARDASIL (Lot number 668262/0841AA; Expired date: 18-APR-2013). Concomitant therapy included SEPTRA. Follow up phone call from the physician was received. The physician reported that the patient had no medical history. The last time he saw the patient was on 22-JUL-2011, when the patient received his second dose of GARDASIL. The physician also reported that there was no indication from the patient that he was troubled. On 27-JUL-2011 the patient committed suicide. The cause of death was asphyxiation by hanging. The death report that the physician received was that the patient had a normal examination. The Toxic screen indicated that there were no medications involved in the patient''s death. The patient''s mother had asked the physician if GARDASIL could have caused her son to commit suicide. The physician reported to the patient''s mother that he did not feel that GARDASIL was the cause of her son''s suicide. The physician stated that he was not aware of any reported deaths by suicide that were related to GARDASIL. Lot checks have been initiated for 668554/0306AA, 668262/0841AA for GARDASIL and 670377/0126AA for VAQTA. Additional information has been requested.


Changed on 6/14/2018

VAERS ID: 437999 Before After
VAERS Form:1
Age:18.0
Sex:Male
Location:Ohio
Vaccinated:2011-07-22
Onset:2011-07-27
Submitted:2011-10-12
Entered:2011-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0126AA / UNK UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0841AA / 2 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Asphyxia, Completed suicide, Death, Drug screen negative, Toxicologic test normal

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-07-27
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: SEPTRA
Current Illness: Acne
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: diagnostic laboratory, ?/?/11, toxic screen indicated that there were no medications involved in the patient''s death.
CDC 'Split Type': WAES1110USA00917

Write-up: Information has been received from a physician concerning an 18 year old male patient with acne and no drug allergy or reaction who on 16-MAY-2011 was vaccinated with the first dose of GARDASIL (Lot number 668554/0306AA; Expired date: 10-MAY-2013) and a dose of VAQTA (Lot number: 670377/0126AA; Expired date: 07-DEC-2013, dose in series unknown). On 22-JUL-2011, the patient received the second dose of GARDASIL (Lot number 668262/0841AA; Expired date: 18-APR-2013). Concomitant therapy included SEPTRA. Follow up phone call from the physician was received. The physician reported that the patient had no medical history. The last time he saw the patient was on 22-JUL-2011, when the patient received his second dose of GARDASIL. The physician also reported that there was no indication from the patient that he was troubled. On 27-JUL-2011 the patient committed suicide. The cause of death was asphyxiation by hanging. The death report that the physician received was that the patient had a normal examination. The Toxic screen indicated that there were no medications involved in the patient''s death. The patient''s mother had asked the physician if GARDASIL could have caused her son to commit suicide. The physician reported to the patient''s mother that he did not feel that GARDASIL was the cause of her son''s suicide. The physician stated that he was not aware of any reported deaths by suicide that were related to GARDASIL. Lot checks have been initiated for 668554/0306AA, 668262/0841AA for GARDASIL and 670377/0126AA for VAQTA. Additional information has been requested.


Changed on 8/14/2018

VAERS ID: 437999 Before After
VAERS Form:1
Age:18.0
Sex:Male
Location:Ohio
Vaccinated:2011-07-22
Onset:2011-07-27
Submitted:2011-10-12
Entered:2011-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0126AA / UNK UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0841AA / 2 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Asphyxia, Completed suicide, Death, Drug screen negative, Toxicologic test normal

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-07-27
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: SEPTRA
Current Illness: Acne
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: diagnostic laboratory, ?/?/11, toxic screen indicated that there were no medications involved in the patient''s death.
CDC 'Split Type': WAES1110USA00917

Write-up: Information has been received from a physician concerning an 18 year old male patient with acne and no drug allergy or reaction who on 16-MAY-2011 was vaccinated with the first dose of GARDASIL (Lot number 668554/0306AA; Expired date: 10-MAY-2013) and a dose of VAQTA (Lot number: 670377/0126AA; Expired date: 07-DEC-2013, dose in series unknown). On 22-JUL-2011, the patient received the second dose of GARDASIL (Lot number 668262/0841AA; Expired date: 18-APR-2013). Concomitant therapy included SEPTRA. Follow up phone call from the physician was received. The physician reported that the patient had no medical history. The last time he saw the patient was on 22-JUL-2011, when the patient received his second dose of GARDASIL. The physician also reported that there was no indication from the patient that he was troubled. On 27-JUL-2011 the patient committed suicide. The cause of death was asphyxiation by hanging. The death report that the physician received was that the patient had a normal examination. The Toxic screen indicated that there were no medications involved in the patient''s death. The patient''s mother had asked the physician if GARDASIL could have caused her son to commit suicide. The physician reported to the patient''s mother that he did not feel that GARDASIL was the cause of her son''s suicide. The physician stated that he was not aware of any reported deaths by suicide that were related to GARDASIL. Lot checks have been initiated for 668554/0306AA, 668262/0841AA for GARDASIL and 670377/0126AA for VAQTA. Additional information has been requested.


Changed on 9/14/2018

VAERS ID: 437999 Before After
VAERS Form:1
Age:18.0
Sex:Male
Location:Ohio
Vaccinated:2011-07-22
Onset:2011-07-27
Submitted:2011-10-12
Entered:2011-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0126AA / UNK UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0841AA / 2 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Asphyxia, Completed suicide, Death, Drug screen negative, Toxicologic test normal

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-07-27
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: SEPTRA
Current Illness: Acne
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: diagnostic laboratory, ?/?/11, toxic screen indicated that there were no medications involved in the patient''s death.
CDC 'Split Type': WAES1110USA00917

Write-up: Information has been received from a physician concerning an 18 year old male patient with acne and no drug allergy or reaction who on 16-MAY-2011 was vaccinated with the first dose of GARDASIL (Lot number 668554/0306AA; Expired date: 10-MAY-2013) and a dose of VAQTA (Lot number: 670377/0126AA; Expired date: 07-DEC-2013, dose in series unknown). On 22-JUL-2011, the patient received the second dose of GARDASIL (Lot number 668262/0841AA; Expired date: 18-APR-2013). Concomitant therapy included SEPTRA. Follow up phone call from the physician was received. The physician reported that the patient had no medical history. The last time he saw the patient was on 22-JUL-2011, when the patient received his second dose of GARDASIL. The physician also reported that there was no indication from the patient that he was troubled. On 27-JUL-2011 the patient committed suicide. The cause of death was asphyxiation by hanging. The death report that the physician received was that the patient had a normal examination. The Toxic screen indicated that there were no medications involved in the patient''s death. The patient''s mother had asked the physician if GARDASIL could have caused her son to commit suicide. The physician reported to the patient''s mother that he did not feel that GARDASIL was the cause of her son''s suicide. The physician stated that he was not aware of any reported deaths by suicide that were related to GARDASIL. Lot checks have been initiated for 668554/0306AA, 668262/0841AA for GARDASIL and 670377/0126AA for VAQTA. Additional information has been requested.


Changed on 10/14/2018

VAERS ID: 437999 Before After
VAERS Form:1
Age:18.0
Sex:Male
Location:Ohio
Vaccinated:2011-07-22
Onset:2011-07-27
Submitted:2011-10-12
Entered:2011-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0126AA / UNK UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0841AA / 2 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Asphyxia, Completed suicide, Death, Drug screen negative, Toxicologic test normal

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-07-27
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: SEPTRA
Current Illness: Acne
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: diagnostic laboratory, ?/?/11, toxic screen indicated that there were no medications involved in the patient''s death.
CDC 'Split Type': WAES1110USA00917

Write-up: Information has been received from a physician concerning an 18 year old male patient with acne and no drug allergy or reaction who on 16-MAY-2011 was vaccinated with the first dose of GARDASIL (Lot number 668554/0306AA; Expired date: 10-MAY-2013) and a dose of VAQTA (Lot number: 670377/0126AA; Expired date: 07-DEC-2013, dose in series unknown). On 22-JUL-2011, the patient received the second dose of GARDASIL (Lot number 668262/0841AA; Expired date: 18-APR-2013). Concomitant therapy included SEPTRA. Follow up phone call from the physician was received. The physician reported that the patient had no medical history. The last time he saw the patient was on 22-JUL-2011, when the patient received his second dose of GARDASIL. The physician also reported that there was no indication from the patient that he was troubled. On 27-JUL-2011 the patient committed suicide. The cause of death was asphyxiation by hanging. The death report that the physician received was that the patient had a normal examination. The Toxic screen indicated that there were no medications involved in the patient''s death. The patient''s mother had asked the physician if GARDASIL could have caused her son to commit suicide. The physician reported to the patient''s mother that he did not feel that GARDASIL was the cause of her son''s suicide. The physician stated that he was not aware of any reported deaths by suicide that were related to GARDASIL. Lot checks have been initiated for 668554/0306AA, 668262/0841AA for GARDASIL and 670377/0126AA for VAQTA. Additional information has been requested.

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