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This is VAERS ID 611323

History of Changes from the VAERS Wayback Machine

First Appeared on 12/14/2015

611323
VAERS Form:
Age:
Gender:Unknown
Location:Connecticut
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2015-11-23
Entered:2015-11-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Paralysis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES1511USA011898

Write-up:This spontaneous report has been received from a physician via a company representative referring to a patient of unknown age (the neighbor of the physician''s mother). The patient''s medical history and concurrent condition were not reported. On an unknown date the patient was vaccinated with an unidentified Merck HPV vaccine (name and lot number not provided) (GARDASIL or GARDASIL 9 could not be ruled out). Concomitant therapy was not reported. It was reported that on an unspecified date the patient was "paralyzed" after being administered the vaccine. The outcome of "paralyzed" was unknown. It was unknown if the patient sought any medical attention. Upon internal review, the event of "paralyzed" was considered to be medically significant and resulted in disability. Additional information has been requested.


Changed on 9/14/2017

611323 Before After
VAERS Form:(blank) 1
Age:
Gender:Unknown
Location:Connecticut
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2015-11-23
Entered:2015-11-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Paralysis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES1511USA011898

Write-up:This spontaneous report has been received from a physician via a company representative referring to a patient of unknown age (the neighbor of the physician''s mother). The patient''s medical history and concurrent condition were not reported. On an unknown date the patient was vaccinated with an unidentified Merck HPV vaccine (name and lot number not provided) (GARDASIL or GARDASIL 9 could not be ruled out). Concomitant therapy was not reported. It was reported that on an unspecified date the patient was "paralyzed" after being administered the vaccine. The outcome of "paralyzed" was unknown. It was unknown if the patient sought any medical attention. Upon internal review, the event of "paralyzed" was considered to be medically significant and resulted in disability. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=611323&WAYBACKHISTORY=ON


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