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This is VAERS ID 661043

History of Changes from the VAERS Wayback Machine

First Appeared on 12/14/2016

VAERS ID: 661043
VAERS Form:
Age:
Sex:Unknown
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2016-10-24
Entered:2016-10-24
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': WAES1610USA011804

Write-up: This spontaneous report was received from a physician via company representative concerning 200 patients of unknown age and gender. The physician reported that an unspecified article provided information regarding patients who on dates were vaccinated with GARDASIL and died an unspecified time after vaccination. There was no product quality complaint reported. The reporter did not provide the causality assessment for the events. the cause of death was not specified. Upon internal review death was considered to be medically significant. Additional information has been requested.


Changed on 9/14/2017

VAERS ID: 661043 Before After
VAERS Form:(blank) 1
Age:
Sex:Unknown
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2016-10-24
Entered:2016-10-24
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': WAES1610USA011804

Write-up: This spontaneous report was received from a physician via company representative concerning 200 patients of unknown age and gender. The physician reported that an unspecified article provided information regarding patients who on dates were vaccinated with GARDASIL and died an unspecified time after vaccination. There was no product quality complaint reported. The reporter did not provide the causality assessment for the events. the cause of death was not specified. Upon internal review death was considered to be medically significant. Additional information has been requested.


Changed on 2/14/2018

VAERS ID: 661043 Before After
VAERS Form:1
Age:
Sex:Unknown
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2016-10-24
Entered:2016-10-24
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': WAES1610USA011804

Write-up: This spontaneous report was received from a physician via company representative concerning 200 patients of unknown age and gender. The physician reported that an unspecified article provided information regarding patients who on dates were vaccinated with GARDASIL and died an unspecified time after vaccination. There was no product quality complaint reported. The reporter did not provide the causality assessment for the events. the cause of death was not specified. Upon internal review death was considered to be medically significant. Additional information has been requested.


Changed on 6/14/2018

VAERS ID: 661043 Before After
VAERS Form:1
Age:
Sex:Unknown
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2016-10-24
Entered:2016-10-24
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': WAES1610USA011804

Write-up: This spontaneous report was received from a physician via company representative concerning 200 patients of unknown age and gender. The physician reported that an unspecified article provided information regarding patients who on dates were vaccinated with GARDASIL and died an unspecified time after vaccination. There was no product quality complaint reported. The reporter did not provide the causality assessment for the events. the cause of death was not specified. Upon internal review death was considered to be medically significant. Additional information has been requested.


Changed on 8/14/2018

VAERS ID: 661043 Before After
VAERS Form:1
Age:
Sex:Unknown
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2016-10-24
Entered:2016-10-24
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': WAES1610USA011804

Write-up: This spontaneous report was received from a physician via company representative concerning 200 patients of unknown age and gender. The physician reported that an unspecified article provided information regarding patients who on dates were vaccinated with GARDASIL and died an unspecified time after vaccination. There was no product quality complaint reported. The reporter did not provide the causality assessment for the events. the cause of death was not specified. Upon internal review death was considered to be medically significant. Additional information has been requested.


Changed on 9/14/2018

VAERS ID: 661043 Before After
VAERS Form:1
Age:
Sex:Unknown
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2016-10-24
Entered:2016-10-24
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': WAES1610USA011804

Write-up: This spontaneous report was received from a physician via company representative concerning 200 patients of unknown age and gender. The physician reported that an unspecified article provided information regarding patients who on dates were vaccinated with GARDASIL and died an unspecified time after vaccination. There was no product quality complaint reported. The reporter did not provide the causality assessment for the events. the cause of death was not specified. Upon internal review death was considered to be medically significant. Additional information has been requested.


Changed on 10/14/2018

VAERS ID: 661043 Before After
VAERS Form:1
Age:
Sex:Unknown
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2016-10-24
Entered:2016-10-24
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': WAES1610USA011804

Write-up: This spontaneous report was received from a physician via company representative concerning 200 patients of unknown age and gender. The physician reported that an unspecified article provided information regarding patients who on dates were vaccinated with GARDASIL and died an unspecified time after vaccination. There was no product quality complaint reported. The reporter did not provide the causality assessment for the events. the cause of death was not specified. Upon internal review death was considered to be medically significant. Additional information has been requested.

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=661043&WAYBACKHISTORY=ON


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