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This is VAERS ID 675213

History of Changes from the VAERS Wayback Machine

First Appeared on 2/14/2017

675213
VAERS Form:
Age:
Gender:Unknown
Location:Foreign
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2016-10-21
Entered:2016-10-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Disability

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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': WAES1610JPN011013

Write-up:Information has been received from an unspecified reporter via social media concerning a patient of unknown age and gender. Information about concurrent condition, concomitant medication and medical history was not provided. On an unspecified date, the patient received GARDASIL (lot#, expire date, dose and route unknown). On an unknown date, the patient became permanently disabled. The relationship between the event and the vaccine was unknown. The outcome was unknown. Upon internal review, disability was determined to be medically significant. This is one of several reports received from the same reporter. Additional information is not expected because of lack of privately contactable information for the reporter.


Changed on 9/14/2017

675213 Before After
VAERS Form:(blank) 1
Age:
Gender:Unknown
Location:Foreign
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2016-10-21
Entered:2016-10-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Disability

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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': WAES1610JPN011013

Write-up:Information has been received from an unspecified reporter via social media concerning a patient of unknown age and gender. Information about concurrent condition, concomitant medication and medical history was not provided. On an unspecified date, the patient received GARDASIL (lot#, expire date, dose and route unknown). On an unknown date, the patient became permanently disabled. The relationship between the event and the vaccine was unknown. The outcome was unknown. Upon internal review, disability was determined to be medically significant. This is one of several reports received from the same reporter. Additional information is not expected because of lack of privately contactable information for the reporter.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=675213&WAYBACKHISTORY=ON


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