National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 698411

History of Changes from the VAERS Wayback Machine

First Appeared on 6/14/2017

698411
VAERS Form:
Age:
Gender:Unknown
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2017-06-06
Entered:2017-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Adverse event

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': US0095075131706USA000362

Write-up:This spontaneous report was received from a physician via a company representative concerning an unspecified patient of an unknown age and gender. The patient''s concurrent conditions, medical history, historical drugs and concomitant therapies were not reported. On an unknown date, the patient was vaccinated with GARDASIL intramuscularly (dose, frequency, lot number and expiration date were not reported) for prevention of human papillomavirus (prophylaxis). The physician reported that he was hearing that somebody in a town close, on an unknown date, experienced an unspecified disabling effect (adverse event). At the time of reporting, the outcome of the event was not reported. The causal relationship between the event and GARDASIL was not reported. The reporter considered the adverse event as a disabling event. Additional information is not expected as there are no contact details available.


Changed on 9/14/2017

698411 Before After
VAERS Form:(blank) 1
Age:
Gender:Unknown
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2017-06-06
Entered:2017-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UNK UN / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Adverse event

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': US0095075131706USA000362

Write-up:This spontaneous report was received from a physician via a company representative concerning an unspecified patient of an unknown age and gender. The patient''s concurrent conditions, medical history, historical drugs and concomitant therapies were not reported. On an unknown date, the patient was vaccinated with GARDASIL intramuscularly (dose, frequency, lot number and expiration date were not reported) for prevention of human papillomavirus (prophylaxis). The physician reported that he was hearing that somebody in a town close, on an unknown date, experienced an unspecified disabling effect (adverse event). At the time of reporting, the outcome of the event was not reported. The causal relationship between the event and GARDASIL was not reported. The reporter considered the adverse event as a disabling event. Additional information is not expected as there are no contact details available.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=698411&WAYBACKHISTORY=ON


Copyright © 2017 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166