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This is VAERS ID 626063

History of Changes from the VAERS Wayback Machine

First Appeared on 3/14/2016

VAERS ID: 626063
VAERS Form:
Age:12.0
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2016-03-08
Entered:2016-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Sudden 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': WAES1508USA010157

Write-up: This spontaneous report was received from a consumer via a social media site concerning a female who on an unspecified date received GARDASIL. Concomitant medications and medical history were not provided. The reporter posted on the social media site. No further information was provided. Follow-up information was received on 04-MAR-2016 from a consumer via social media concerning a female who was reported to have received a dose of GARDASIL. It was reported: "The sudden death of a 12 year old girl... just hours after receiving the HPV GARDASIL vaccine has shocked the girl''s family and sent local medical asking questions as [...]". No other information was provided. Additional information is not expected.


Changed on 9/14/2017

VAERS ID: 626063 Before After
VAERS Form:(blank) 1
Age:12.0
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2016-03-08
Entered:2016-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Sudden 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': WAES1508USA010157

Write-up: This spontaneous report was received from a consumer via a social media site concerning a female who on an unspecified date received GARDASIL. Concomitant medications and medical history were not provided. The reporter posted on the social media site. No further information was provided. Follow-up information was received on 04-MAR-2016 from a consumer via social media concerning a female who was reported to have received a dose of GARDASIL. It was reported: "The sudden death of a 12 year old girl... just hours after receiving the HPV GARDASIL vaccine has shocked the girl''s family and sent local medical asking questions as [...]". No other information was provided. Additional information is not expected.


Changed on 2/14/2018

VAERS ID: 626063 Before After
VAERS Form:1
Age:12.0
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2016-03-08
Entered:2016-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Sudden 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': WAES1508USA010157

Write-up: This spontaneous report was received from a consumer via a social media site concerning a female who on an unspecified date received GARDASIL. Concomitant medications and medical history were not provided. The reporter posted on the social media site. No further information was provided. Follow-up information was received on 04-MAR-2016 from a consumer via social media concerning a female who was reported to have received a dose of GARDASIL. It was reported: "The sudden death of a 12 year old girl... just hours after receiving the HPV GARDASIL vaccine has shocked the girl''s family and sent local medical asking questions as [...]". No other information was provided. Additional information is not expected.


Changed on 6/14/2018

VAERS ID: 626063 Before After
VAERS Form:1
Age:12.0
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2016-03-08
Entered:2016-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Sudden 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': WAES1508USA010157

Write-up: This spontaneous report was received from a consumer via a social media site concerning a female who on an unspecified date received GARDASIL. Concomitant medications and medical history were not provided. The reporter posted on the social media site. No further information was provided. Follow-up information was received on 04-MAR-2016 from a consumer via social media concerning a female who was reported to have received a dose of GARDASIL. It was reported: "The sudden death of a 12 year old girl... just hours after receiving the HPV GARDASIL vaccine has shocked the girl''s family and sent local medical asking questions as [...]". No other information was provided. Additional information is not expected.


Changed on 8/14/2018

VAERS ID: 626063 Before After
VAERS Form:1
Age:12.0
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2016-03-08
Entered:2016-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Sudden 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': WAES1508USA010157

Write-up: This spontaneous report was received from a consumer via a social media site concerning a female who on an unspecified date received GARDASIL. Concomitant medications and medical history were not provided. The reporter posted on the social media site. No further information was provided. Follow-up information was received on 04-MAR-2016 from a consumer via social media concerning a female who was reported to have received a dose of GARDASIL. It was reported: "The sudden death of a 12 year old girl... just hours after receiving the HPV GARDASIL vaccine has shocked the girl''s family and sent local medical asking questions as [...]". No other information was provided. Additional information is not expected.


Changed on 9/14/2018

VAERS ID: 626063 Before After
VAERS Form:1
Age:12.0
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2016-03-08
Entered:2016-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Sudden 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': WAES1508USA010157

Write-up: This spontaneous report was received from a consumer via a social media site concerning a female who on an unspecified date received GARDASIL. Concomitant medications and medical history were not provided. The reporter posted on the social media site. No further information was provided. Follow-up information was received on 04-MAR-2016 from a consumer via social media concerning a female who was reported to have received a dose of GARDASIL. It was reported: "The sudden death of a 12 year old girl... just hours after receiving the HPV GARDASIL vaccine has shocked the girl''s family and sent local medical asking questions as [...]". No other information was provided. Additional information is not expected.


Changed on 10/14/2018

VAERS ID: 626063 Before After
VAERS Form:1
Age:12.0
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2016-03-08
Entered:2016-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Sudden 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': WAES1508USA010157

Write-up: This spontaneous report was received from a consumer via a social media site concerning a female who on an unspecified date received GARDASIL. Concomitant medications and medical history were not provided. The reporter posted on the social media site. No further information was provided. Follow-up information was received on 04-MAR-2016 from a consumer via social media concerning a female who was reported to have received a dose of GARDASIL. It was reported: "The sudden death of a 12 year old girl... just hours after receiving the HPV GARDASIL vaccine has shocked the girl''s family and sent local medical asking questions as [...]". No other information was provided. Additional information is not expected.

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=626063&WAYBACKHISTORY=ON


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