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This is VAERS ID 541768

History of Changes from the VAERS Wayback Machine

First Appeared on 9/14/2014

541768
VAERS Form:
Age:
Gender:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2014-08-29
Entered:2014-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Guillain-Barre syndrome

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES1408USA014775

Write-up:This spontaneous report was received from a physician assistant, via a company representative, concerning a female patient of unknown age. Medical history and concurrent conditions were not reported. In approximately 2013 (reported as about a year ago) the patient was vaccinated with a dose of GARDASIL (dose, dose number, lot number, expiration date and route were not reported). Co-suspect and concomitant therapies were not reported. The physician assistant reported to the representative, "about a year ago, approximately in 2013, 1 week after receiving GARDASIL the anonymous patient (demographics unknown) developed Guillain-Barre and was hospitalized". The outcome of "Guillain-Barre" was reported as recovered on an unknown date. Patient sought medical attention. The physician assistant considered the event as serious due the disability. Upon internal review the event "Guillain-Barre" was considered as Medically significant. Additional information has been requested.


Changed on 9/14/2017

541768 Before After
VAERS Form:(blank) 1
Age:
Gender:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2014-08-29
Entered:2014-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Guillain-Barre syndrome

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES1408USA014775

Write-up:This spontaneous report was received from a physician assistant, via a company representative, concerning a female patient of unknown age. Medical history and concurrent conditions were not reported. In approximately 2013 (reported as about a year ago) the patient was vaccinated with a dose of GARDASIL (dose, dose number, lot number, expiration date and route were not reported). Co-suspect and concomitant therapies were not reported. The physician assistant reported to the representative, "about a year ago, approximately in 2013, 1 week after receiving GARDASIL the anonymous patient (demographics unknown) developed Guillain-Barre and was hospitalized". The outcome of "Guillain-Barre" was reported as recovered on an unknown date. Patient sought medical attention. The physician assistant considered the event as serious due the disability. Upon internal review the event "Guillain-Barre" was considered as Medically significant. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=541768&WAYBACKHISTORY=ON


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