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This is VAERS ID 515434

History of Changes from the VAERS Wayback Machine

First Appeared on 12/13/2013

VAERS ID: 515434
VAERS Form:
Age:16.0
Sex:Male
Location:Louisiana
Vaccinated:2013-05-23
Onset:2013-07-04
Submitted:2013-12-03
Entered:2013-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Sudden death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2013-07-04
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: ALBUTEROL
Current Illness: No illnesses at time of vaccination
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Sudden death. He was perfectly healthy. This vaccination is the only thing I can think of that would have caused this. Everything else in his life was normal, the same.


Changed on 3/14/2014

VAERS ID: 515434 Before After
VAERS Form:
Age:16.0
Sex:Male
Location:Louisiana
Vaccinated:2013-05-23
Onset:2013-07-04
Submitted:2013-12-03
Entered:2013-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - H016238 / 1 0 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Sudden death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2013-07-04
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: ALBUTEROL
Current Illness: No illnesses at time of vaccination
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Sudden death. He was perfectly healthy. This vaccination is the only thing I can think of that would have caused this. Everything else in his life was normal, the same.


Changed on 6/14/2014

VAERS ID: 515434 Before After
VAERS Form:
Age:16.0
Sex:Male
Location:Louisiana
Vaccinated:2013-05-23
Onset:2013-07-04
Submitted:2013-12-03
Entered:2013-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. H016238 / 0 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Sudden death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2013-07-04
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: ALBUTEROL
Current Illness: No illnesses at time of vaccination
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Sudden death. He was perfectly healthy. This vaccination is the only thing I can think of that would have caused this. Everything else in his life was normal, the same.


Changed on 3/14/2015

VAERS ID: 515434 Before After
VAERS Form:
Age:16.0
Sex:Male
Location:Louisiana
Vaccinated:2013-05-23
Onset:2013-07-04
Submitted:2013-12-03
Entered:2013-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. H016238 / 0 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Sudden death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2013-07-04
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: ALBUTEROL
Current Illness: No illnesses at time of vaccination
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Sudden death. He was perfectly healthy. This vaccination is the only thing I can think of that would have caused this. Everything else in his life was normal, the same.


Changed on 9/14/2017

VAERS ID: 515434 Before After
VAERS Form:(blank) 1
Age:16.0
Sex:Male
Location:Louisiana
Vaccinated:2013-05-23
Onset:2013-07-04
Submitted:2013-12-03
Entered:2013-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. H016238 / 0 1 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Sudden death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2013-07-04
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: ALBUTEROL
Current Illness: No illnesses at time of vaccination
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Sudden death. He was perfectly healthy. This vaccination is the only thing I can think of that would have caused this. Everything else in his life was normal, the same.


Changed on 2/14/2018

VAERS ID: 515434 Before After
VAERS Form:1
Age:16.0
Sex:Male
Location:Louisiana
Vaccinated:2013-05-23
Onset:2013-07-04
Submitted:2013-12-03
Entered:2013-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. H016238 / 1 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Sudden death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2013-07-04
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: ALBUTEROL
Current Illness: No illnesses at time of vaccination
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Sudden death. He was perfectly healthy. This vaccination is the only thing I can think of that would have caused this. Everything else in his life was normal, the same.


Changed on 6/14/2018

VAERS ID: 515434 Before After
VAERS Form:1
Age:16.0
Sex:Male
Location:Louisiana
Vaccinated:2013-05-23
Onset:2013-07-04
Submitted:2013-12-03
Entered:2013-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. H016238 / 1 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Sudden death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2013-07-04
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: ALBUTEROL
Current Illness: No illnesses at time of vaccination
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Sudden death. He was perfectly healthy. This vaccination is the only thing I can think of that would have caused this. Everything else in his life was normal, the same.


Changed on 8/14/2018

VAERS ID: 515434 Before After
VAERS Form:1
Age:16.0
Sex:Male
Location:Louisiana
Vaccinated:2013-05-23
Onset:2013-07-04
Submitted:2013-12-03
Entered:2013-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. H016238 / 1 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Sudden death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2013-07-04
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: ALBUTEROL
Current Illness: No illnesses at time of vaccination
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Sudden death. He was perfectly healthy. This vaccination is the only thing I can think of that would have caused this. Everything else in his life was normal, the same.


Changed on 9/14/2018

VAERS ID: 515434 Before After
VAERS Form:1
Age:16.0
Sex:Male
Location:Louisiana
Vaccinated:2013-05-23
Onset:2013-07-04
Submitted:2013-12-03
Entered:2013-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. H016238 / 1 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Sudden death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2013-07-04
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: ALBUTEROL
Current Illness: No illnesses at time of vaccination
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Sudden death. He was perfectly healthy. This vaccination is the only thing I can think of that would have caused this. Everything else in his life was normal, the same.


Changed on 10/14/2018

VAERS ID: 515434 Before After
VAERS Form:1
Age:16.0
Sex:Male
Location:Louisiana
Vaccinated:2013-05-23
Onset:2013-07-04
Submitted:2013-12-03
Entered:2013-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. H016238 / 1 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Sudden death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2013-07-04
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: ALBUTEROL
Current Illness: No illnesses at time of vaccination
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Sudden death. He was perfectly healthy. This vaccination is the only thing I can think of that would have caused this. Everything else in his life was normal, the same.

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