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This is VAERS ID 671533

History of Changes from the VAERS Wayback Machine

First Appeared on 12/14/2016

VAERS ID: 671533
VAERS Form:
Age:
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:2016-11-01
Submitted:2016-12-12
Entered:2016-12-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN

Administered by: Unknown      Purchased by: Unknown
Symptoms: Death, Adverse event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2016-11-01
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': US0095075131612USA005706

Write-up: This spontaneous report was received on 09-DEC-2016 from the grandmother of an 11 year old female who experienced adverse events after receiving GARDASIL (see case # 1612USA005619). The reporter stated that in November 2016 (reported as three and a half weeks ago), a friend of her grandaughter''s died. It was unclear from the statement whether this girl received GARDASIL before her death. Cause of death was not reported. Upon internal review, died was considered medically significant. Additional information is not expected as the reporter did not provide contact information. Sender''s Comments: US-009507513-1612USA005619: Reported Cause(s) of Death: died.


Changed on 9/14/2017

VAERS ID: 671533 Before After
VAERS Form:(blank) 1
Age:
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:2016-11-01
Submitted:2016-12-12
Entered:2016-12-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UNK UN / UN

Administered by: Unknown      Purchased by: Unknown
Symptoms: Death, Adverse event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2016-11-01
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': US0095075131612USA005706

Write-up: This spontaneous report was received on 09-DEC-2016 from the grandmother of an 11 year old female who experienced adverse events after receiving GARDASIL (see case # 1612USA005619). The reporter stated that in November 2016 (reported as three and a half weeks ago), a friend of her grandaughter''s died. It was unclear from the statement whether this girl received GARDASIL before her death. Cause of death was not reported. Upon internal review, died was considered medically significant. Additional information is not expected as the reporter did not provide contact information. Sender''s Comments: US-009507513-1612USA005619: Reported Cause(s) of Death: died.


Changed on 2/14/2018

VAERS ID: 671533 Before After
VAERS Form:1
Age:
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:2016-11-01
Submitted:2016-12-12
Entered:2016-12-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Unknown      Purchased by: Unknown
Symptoms: Death, Adverse event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2016-11-01
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': US0095075131612USA005706

Write-up: This spontaneous report was received on 09-DEC-2016 from the grandmother of an 11 year old female who experienced adverse events after receiving GARDASIL (see case # 1612USA005619). The reporter stated that in November 2016 (reported as three and a half weeks ago), a friend of her grandaughter''s died. It was unclear from the statement whether this girl received GARDASIL before her death. Cause of death was not reported. Upon internal review, died was considered medically significant. Additional information is not expected as the reporter did not provide contact information. Sender''s Comments: US-009507513-1612USA005619: Reported Cause(s) of Death: died.


Changed on 6/14/2018

VAERS ID: 671533 Before After
VAERS Form:1
Age:
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:2016-11-01
Submitted:2016-12-12
Entered:2016-12-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Unknown      Purchased by: Unknown
Symptoms: Death, Adverse event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2016-11-01
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': US0095075131612USA005706

Write-up: This spontaneous report was received on 09-DEC-2016 from the grandmother of an 11 year old female who experienced adverse events after receiving GARDASIL (see case # 1612USA005619). The reporter stated that in November 2016 (reported as three and a half weeks ago), a friend of her grandaughter''s died. It was unclear from the statement whether this girl received GARDASIL before her death. Cause of death was not reported. Upon internal review, died was considered medically significant. Additional information is not expected as the reporter did not provide contact information. Sender''s Comments: US-009507513-1612USA005619: Reported Cause(s) of Death: died.


Changed on 8/14/2018

VAERS ID: 671533 Before After
VAERS Form:1
Age:
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:2016-11-01
Submitted:2016-12-12
Entered:2016-12-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Unknown      Purchased by: Unknown
Symptoms: Death, Adverse event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2016-11-01
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': US0095075131612USA005706

Write-up: This spontaneous report was received on 09-DEC-2016 from the grandmother of an 11 year old female who experienced adverse events after receiving GARDASIL (see case # 1612USA005619). The reporter stated that in November 2016 (reported as three and a half weeks ago), a friend of her grandaughter''s died. It was unclear from the statement whether this girl received GARDASIL before her death. Cause of death was not reported. Upon internal review, died was considered medically significant. Additional information is not expected as the reporter did not provide contact information. Sender''s Comments: US-009507513-1612USA005619: Reported Cause(s) of Death: died.


Changed on 9/14/2018

VAERS ID: 671533 Before After
VAERS Form:1
Age:
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:2016-11-01
Submitted:2016-12-12
Entered:2016-12-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Unknown      Purchased by: Unknown
Symptoms: Death, Adverse event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2016-11-01
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': US0095075131612USA005706

Write-up: This spontaneous report was received on 09-DEC-2016 from the grandmother of an 11 year old female who experienced adverse events after receiving GARDASIL (see case # 1612USA005619). The reporter stated that in November 2016 (reported as three and a half weeks ago), a friend of her grandaughter''s died. It was unclear from the statement whether this girl received GARDASIL before her death. Cause of death was not reported. Upon internal review, died was considered medically significant. Additional information is not expected as the reporter did not provide contact information. Sender''s Comments: US-009507513-1612USA005619: Reported Cause(s) of Death: died.


Changed on 10/14/2018

VAERS ID: 671533 Before After
VAERS Form:1
Age:
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:2016-11-01
Submitted:2016-12-12
Entered:2016-12-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Unknown      Purchased by: Unknown
Symptoms: Death, Adverse event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2016-11-01
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': US0095075131612USA005706

Write-up: This spontaneous report was received on 09-DEC-2016 from the grandmother of an 11 year old female who experienced adverse events after receiving GARDASIL (see case # 1612USA005619). The reporter stated that in November 2016 (reported as three and a half weeks ago), a friend of her grandaughter''s died. It was unclear from the statement whether this girl received GARDASIL before her death. Cause of death was not reported. Upon internal review, died was considered medically significant. Additional information is not expected as the reporter did not provide contact information. Sender''s Comments: US-009507513-1612USA005619: Reported Cause(s) of Death: died.

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=671533&WAYBACKHISTORY=ON


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