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This is VAERS ID 622366

History of Changes from the VAERS Wayback Machine

First Appeared on 2/14/2016

VAERS ID: 622366
VAERS Form:
Age:14.0
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2016-02-11
Entered:2016-02-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Death

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': WAES1602USA005295

Write-up: This spontaneous report was received from a consumer referring to a 14 year old male patient. The patient''s concurrent conditions and medical history were not provided. On an unknown date the patient was vaccinated with a dose of GARDASIL (dose, route, lot # and expiration date were not provided). Concomitant therapies were not reported. On an unspecified date the patient died. It was unknown if an autopsy was performed and which was the exact cause of death. On an unknown date the reporter wrote on the "Merck Corporate Twitter Account". The relatedness between death and GARDASIL was unknown. Additional information is not expected as the reporter did not provide contact details.


Changed on 9/14/2017

VAERS ID: 622366 Before After
VAERS Form:(blank) 1
Age:14.0
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2016-02-11
Entered:2016-02-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Death

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': WAES1602USA005295

Write-up: This spontaneous report was received from a consumer referring to a 14 year old male patient. The patient''s concurrent conditions and medical history were not provided. On an unknown date the patient was vaccinated with a dose of GARDASIL (dose, route, lot # and expiration date were not provided). Concomitant therapies were not reported. On an unspecified date the patient died. It was unknown if an autopsy was performed and which was the exact cause of death. On an unknown date the reporter wrote on the "Merck Corporate Twitter Account". The relatedness between death and GARDASIL was unknown. Additional information is not expected as the reporter did not provide contact details.


Changed on 2/14/2018

VAERS ID: 622366 Before After
VAERS Form:1
Age:14.0
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2016-02-11
Entered:2016-02-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Death

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': WAES1602USA005295

Write-up: This spontaneous report was received from a consumer referring to a 14 year old male patient. The patient''s concurrent conditions and medical history were not provided. On an unknown date the patient was vaccinated with a dose of GARDASIL (dose, route, lot # and expiration date were not provided). Concomitant therapies were not reported. On an unspecified date the patient died. It was unknown if an autopsy was performed and which was the exact cause of death. On an unknown date the reporter wrote on the "Merck Corporate Twitter Account". The relatedness between death and GARDASIL was unknown. Additional information is not expected as the reporter did not provide contact details.


Changed on 6/14/2018

VAERS ID: 622366 Before After
VAERS Form:1
Age:14.0
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2016-02-11
Entered:2016-02-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Death

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': WAES1602USA005295

Write-up: This spontaneous report was received from a consumer referring to a 14 year old male patient. The patient''s concurrent conditions and medical history were not provided. On an unknown date the patient was vaccinated with a dose of GARDASIL (dose, route, lot # and expiration date were not provided). Concomitant therapies were not reported. On an unspecified date the patient died. It was unknown if an autopsy was performed and which was the exact cause of death. On an unknown date the reporter wrote on the "Merck Corporate Twitter Account". The relatedness between death and GARDASIL was unknown. Additional information is not expected as the reporter did not provide contact details.


Changed on 8/14/2018

VAERS ID: 622366 Before After
VAERS Form:1
Age:14.0
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2016-02-11
Entered:2016-02-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Death

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': WAES1602USA005295

Write-up: This spontaneous report was received from a consumer referring to a 14 year old male patient. The patient''s concurrent conditions and medical history were not provided. On an unknown date the patient was vaccinated with a dose of GARDASIL (dose, route, lot # and expiration date were not provided). Concomitant therapies were not reported. On an unspecified date the patient died. It was unknown if an autopsy was performed and which was the exact cause of death. On an unknown date the reporter wrote on the "Merck Corporate Twitter Account". The relatedness between death and GARDASIL was unknown. Additional information is not expected as the reporter did not provide contact details.


Changed on 9/14/2018

VAERS ID: 622366 Before After
VAERS Form:1
Age:14.0
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2016-02-11
Entered:2016-02-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Death

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': WAES1602USA005295

Write-up: This spontaneous report was received from a consumer referring to a 14 year old male patient. The patient''s concurrent conditions and medical history were not provided. On an unknown date the patient was vaccinated with a dose of GARDASIL (dose, route, lot # and expiration date were not provided). Concomitant therapies were not reported. On an unspecified date the patient died. It was unknown if an autopsy was performed and which was the exact cause of death. On an unknown date the reporter wrote on the "Merck Corporate Twitter Account". The relatedness between death and GARDASIL was unknown. Additional information is not expected as the reporter did not provide contact details.


Changed on 10/14/2018

VAERS ID: 622366 Before After
VAERS Form:1
Age:14.0
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2016-02-11
Entered:2016-02-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Death

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': WAES1602USA005295

Write-up: This spontaneous report was received from a consumer referring to a 14 year old male patient. The patient''s concurrent conditions and medical history were not provided. On an unknown date the patient was vaccinated with a dose of GARDASIL (dose, route, lot # and expiration date were not provided). Concomitant therapies were not reported. On an unspecified date the patient died. It was unknown if an autopsy was performed and which was the exact cause of death. On an unknown date the reporter wrote on the "Merck Corporate Twitter Account". The relatedness between death and GARDASIL was unknown. Additional information is not expected as the reporter did not provide contact details.

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=622366&WAYBACKHISTORY=ON


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