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This is VAERS ID 619116

History of Changes from the VAERS Wayback Machine

First Appeared on 2/14/2016

VAERS ID: 619116
VAERS Form:
Age:
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2016-01-15
Entered:2016-01-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Bone cancer, Death, Incorrect route of drug administration

Life Threatening? No
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: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES1601USA004692

Write-up: Information has been received from a physician via company representative referring to a male patient of unknown age. The patient''s pertinent medical history and drug allergies were not reported. On an unknown date the patient was vaccinated with a dose of GARDASIL (lot#, dose and strength unknown) subdermally. Later the patient died from bone cancer on an unknown date. It was unknown if autopsy was done. Causality was not provided. Additional information has been requested.


Changed on 9/14/2017

VAERS ID: 619116 Before After
VAERS Form:(blank) 1
Age:
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2016-01-15
Entered:2016-01-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Bone cancer, Death, Incorrect route of drug administration

Life Threatening? No
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: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES1601USA004692

Write-up: Information has been received from a physician via company representative referring to a male patient of unknown age. The patient''s pertinent medical history and drug allergies were not reported. On an unknown date the patient was vaccinated with a dose of GARDASIL (lot#, dose and strength unknown) subdermally. Later the patient died from bone cancer on an unknown date. It was unknown if autopsy was done. Causality was not provided. Additional information has been requested.


Changed on 2/14/2018

VAERS ID: 619116 Before After
VAERS Form:1
Age:
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2016-01-15
Entered:2016-01-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Bone cancer, Death, Incorrect route of drug administration

Life Threatening? No
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: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES1601USA004692

Write-up: Information has been received from a physician via company representative referring to a male patient of unknown age. The patient''s pertinent medical history and drug allergies were not reported. On an unknown date the patient was vaccinated with a dose of GARDASIL (lot#, dose and strength unknown) subdermally. Later the patient died from bone cancer on an unknown date. It was unknown if autopsy was done. Causality was not provided. Additional information has been requested.


Changed on 6/14/2018

VAERS ID: 619116 Before After
VAERS Form:1
Age:
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2016-01-15
Entered:2016-01-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Bone cancer, Death, Incorrect route of drug administration

Life Threatening? No
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: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES1601USA004692

Write-up: Information has been received from a physician via company representative referring to a male patient of unknown age. The patient''s pertinent medical history and drug allergies were not reported. On an unknown date the patient was vaccinated with a dose of GARDASIL (lot#, dose and strength unknown) subdermally. Later the patient died from bone cancer on an unknown date. It was unknown if autopsy was done. Causality was not provided. Additional information has been requested.


Changed on 8/14/2018

VAERS ID: 619116 Before After
VAERS Form:1
Age:
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2016-01-15
Entered:2016-01-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Bone cancer, Death, Incorrect route of drug administration

Life Threatening? No
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: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES1601USA004692

Write-up: Information has been received from a physician via company representative referring to a male patient of unknown age. The patient''s pertinent medical history and drug allergies were not reported. On an unknown date the patient was vaccinated with a dose of GARDASIL (lot#, dose and strength unknown) subdermally. Later the patient died from bone cancer on an unknown date. It was unknown if autopsy was done. Causality was not provided. Additional information has been requested.


Changed on 9/14/2018

VAERS ID: 619116 Before After
VAERS Form:1
Age:
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2016-01-15
Entered:2016-01-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Bone cancer, Death, Incorrect route of drug administration

Life Threatening? No
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: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES1601USA004692

Write-up: Information has been received from a physician via company representative referring to a male patient of unknown age. The patient''s pertinent medical history and drug allergies were not reported. On an unknown date the patient was vaccinated with a dose of GARDASIL (lot#, dose and strength unknown) subdermally. Later the patient died from bone cancer on an unknown date. It was unknown if autopsy was done. Causality was not provided. Additional information has been requested.


Changed on 10/14/2018

VAERS ID: 619116 Before After
VAERS Form:1
Age:
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2016-01-15
Entered:2016-01-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Bone cancer, Death, Incorrect route of drug administration

Life Threatening? No
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: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES1601USA004692

Write-up: Information has been received from a physician via company representative referring to a male patient of unknown age. The patient''s pertinent medical history and drug allergies were not reported. On an unknown date the patient was vaccinated with a dose of GARDASIL (lot#, dose and strength unknown) subdermally. Later the patient died from bone cancer on an unknown date. It was unknown if autopsy was done. Causality was not provided. Additional information has been requested.

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=619116&WAYBACKHISTORY=ON


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