National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 582025

History of Changes from the VAERS Wayback Machine

First Appeared on 12/14/2017

VAERS ID: 582025
VAERS Form:1
Age:16.0
Sex:Female
Location:Foreign
Vaccinated:2014-02-01
Onset:2015-05-01
Submitted:2015-06-11
Entered:2015-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 2 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Condition aggravated, Death, Syncope

Life Threatening? Yes
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: No other medications
Current Illness: Cardiac disorder; Systemic lupus erythematosus
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES1506COL004105

Write-up: This spontaneous report was received a social media, TV news refers to a 16 year old female patient. The patient''s current condition included lupus and unspecified heart disease and medial history was not reported. On an unknown date in February 2014, the patient was vaccinated with second dose of GARDASIL (vial and prefilled syringe) intramuscularly (strength and frequency were not reported). Concomitant medications were not reported. On an unknown date after vaccination patient experienced fainting and worsening of pre-existing conditions (Lupus (death, life threatening and medically significant) and unspecified heart disease (death and life threatening). The outcome of worsening of pre-existing conditions (Lupus and unspecified heart disease) was reported as fatal. The outcome of fainting was unknown. The patient died on an unknown date in May 2015. The cause of death was unknown. The relatedness of the events with the quadrivalent human papillomavirus (types 6, 11, 16, 18) recomb. Vaccine was not reported. Upon internal review, worsening of pre-existing conditions (Lupus) was determined to be serious as another important medical event. Additional information is not expected as the contact details were not reported.


Changed on 2/14/2018

VAERS ID: 582025 Before After
VAERS Form:1
Age:16.0
Sex:Female
Location:Foreign
Vaccinated:2014-02-01
Onset:2015-05-01
Submitted:2015-06-11
Entered:2015-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 2 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Condition aggravated, Death, Syncope

Life Threatening? Yes
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: No other medications
Current Illness: Cardiac disorder; Systemic lupus erythematosus
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES1506COL004105

Write-up: This spontaneous report was received a social media, TV news refers to a 16 year old female patient. The patient''s current condition included lupus and unspecified heart disease and medial history was not reported. On an unknown date in February 2014, the patient was vaccinated with second dose of GARDASIL (vial and prefilled syringe) intramuscularly (strength and frequency were not reported). Concomitant medications were not reported. On an unknown date after vaccination patient experienced fainting and worsening of pre-existing conditions (Lupus (death, life threatening and medically significant) and unspecified heart disease (death and life threatening). The outcome of worsening of pre-existing conditions (Lupus and unspecified heart disease) was reported as fatal. The outcome of fainting was unknown. The patient died on an unknown date in May 2015. The cause of death was unknown. The relatedness of the events with the quadrivalent human papillomavirus (types 6, 11, 16, 18) recomb. Vaccine was not reported. Upon internal review, worsening of pre-existing conditions (Lupus) was determined to be serious as another important medical event. Additional information is not expected as the contact details were not reported.


Changed on 6/14/2018

VAERS ID: 582025 Before After
VAERS Form:1
Age:16.0
Sex:Female
Location:Foreign
Vaccinated:2014-02-01
Onset:2015-05-01
Submitted:2015-06-11
Entered:2015-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 2 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Condition aggravated, Death, Syncope

Life Threatening? Yes
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: No other medications
Current Illness: Cardiac disorder; Systemic lupus erythematosus
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES1506COL004105

Write-up: This spontaneous report was received a social media, TV news refers to a 16 year old female patient. The patient''s current condition included lupus and unspecified heart disease and medial history was not reported. On an unknown date in February 2014, the patient was vaccinated with second dose of GARDASIL (vial and prefilled syringe) intramuscularly (strength and frequency were not reported). Concomitant medications were not reported. On an unknown date after vaccination patient experienced fainting and worsening of pre-existing conditions (Lupus (death, life threatening and medically significant) and unspecified heart disease (death and life threatening). The outcome of worsening of pre-existing conditions (Lupus and unspecified heart disease) was reported as fatal. The outcome of fainting was unknown. The patient died on an unknown date in May 2015. The cause of death was unknown. The relatedness of the events with the quadrivalent human papillomavirus (types 6, 11, 16, 18) recomb. Vaccine was not reported. Upon internal review, worsening of pre-existing conditions (Lupus) was determined to be serious as another important medical event. Additional information is not expected as the contact details were not reported.


Changed on 8/14/2018

VAERS ID: 582025 Before After
VAERS Form:1
Age:16.0
Sex:Female
Location:Foreign
Vaccinated:2014-02-01
Onset:2015-05-01
Submitted:2015-06-11
Entered:2015-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 2 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Condition aggravated, Death, Syncope

Life Threatening? Yes
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: No other medications
Current Illness: Cardiac disorder; Systemic lupus erythematosus
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES1506COL004105

Write-up: This spontaneous report was received a social media, TV news refers to a 16 year old female patient. The patient''s current condition included lupus and unspecified heart disease and medial history was not reported. On an unknown date in February 2014, the patient was vaccinated with second dose of GARDASIL (vial and prefilled syringe) intramuscularly (strength and frequency were not reported). Concomitant medications were not reported. On an unknown date after vaccination patient experienced fainting and worsening of pre-existing conditions (Lupus (death, life threatening and medically significant) and unspecified heart disease (death and life threatening). The outcome of worsening of pre-existing conditions (Lupus and unspecified heart disease) was reported as fatal. The outcome of fainting was unknown. The patient died on an unknown date in May 2015. The cause of death was unknown. The relatedness of the events with the quadrivalent human papillomavirus (types 6, 11, 16, 18) recomb. Vaccine was not reported. Upon internal review, worsening of pre-existing conditions (Lupus) was determined to be serious as another important medical event. Additional information is not expected as the contact details were not reported.


Changed on 9/14/2018

VAERS ID: 582025 Before After
VAERS Form:1
Age:16.0
Sex:Female
Location:Foreign
Vaccinated:2014-02-01
Onset:2015-05-01
Submitted:2015-06-11
Entered:2015-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 2 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Condition aggravated, Death, Syncope

Life Threatening? Yes
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: No other medications
Current Illness: Cardiac disorder; Systemic lupus erythematosus
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES1506COL004105

Write-up: This spontaneous report was received a social media, TV news refers to a 16 year old female patient. The patient''s current condition included lupus and unspecified heart disease and medial history was not reported. On an unknown date in February 2014, the patient was vaccinated with second dose of GARDASIL (vial and prefilled syringe) intramuscularly (strength and frequency were not reported). Concomitant medications were not reported. On an unknown date after vaccination patient experienced fainting and worsening of pre-existing conditions (Lupus (death, life threatening and medically significant) and unspecified heart disease (death and life threatening). The outcome of worsening of pre-existing conditions (Lupus and unspecified heart disease) was reported as fatal. The outcome of fainting was unknown. The patient died on an unknown date in May 2015. The cause of death was unknown. The relatedness of the events with the quadrivalent human papillomavirus (types 6, 11, 16, 18) recomb. Vaccine was not reported. Upon internal review, worsening of pre-existing conditions (Lupus) was determined to be serious as another important medical event. Additional information is not expected as the contact details were not reported.


Changed on 10/14/2018

VAERS ID: 582025 Before After
VAERS Form:1
Age:16.0
Sex:Female
Location:Foreign
Vaccinated:2014-02-01
Onset:2015-05-01
Submitted:2015-06-11
Entered:2015-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 2 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Condition aggravated, Death, Syncope

Life Threatening? Yes
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: No other medications
Current Illness: Cardiac disorder; Systemic lupus erythematosus
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES1506COL004105

Write-up: This spontaneous report was received a social media, TV news refers to a 16 year old female patient. The patient''s current condition included lupus and unspecified heart disease and medial history was not reported. On an unknown date in February 2014, the patient was vaccinated with second dose of GARDASIL (vial and prefilled syringe) intramuscularly (strength and frequency were not reported). Concomitant medications were not reported. On an unknown date after vaccination patient experienced fainting and worsening of pre-existing conditions (Lupus (death, life threatening and medically significant) and unspecified heart disease (death and life threatening). The outcome of worsening of pre-existing conditions (Lupus and unspecified heart disease) was reported as fatal. The outcome of fainting was unknown. The patient died on an unknown date in May 2015. The cause of death was unknown. The relatedness of the events with the quadrivalent human papillomavirus (types 6, 11, 16, 18) recomb. Vaccine was not reported. Upon internal review, worsening of pre-existing conditions (Lupus) was determined to be serious as another important medical event. Additional information is not expected as the contact details were not reported.

New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=582025&WAYBACKHISTORY=ON


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