National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 830566

History of Changes from the VAERS Wayback Machine

First Appeared on 9/14/2019

VAERS ID: 830566
VAERS Form:2
Age:
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:2019-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK - / -
HPV9: HPV (GARDASIL 9) / MERCK & CO. INC. - / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Death, Pyrexia

Life Threatening? Yes
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': US0095075131908USA007430

Write-up: The patient developed a fever, was hospitalized at an unspecified hospital for an unspecified length of time; The patient "eventually died" on an unspecified date several years ago. Cause of death: unknown; This spontaneous report was received from the pharmacist via a company representative, referring to a 16-year-old female patient. The patient''s current conditions, medical history, concomitant medications, drug reactions or allergies were not reported. On an unknown date (reported as "several years ago"), the patient received unidentified Merck hpv vaccine administered (name and lot for prophylaxis (dose, strength, lot# and expiration date were not reported) or HPV rL1 6 11 16 18 31 33 45 52 58 VLP vaccine (yeast) (GARDASIL 9) as prophylaxis (dose, strength, lot# and expiration date were not reported). The patient was vaccinated at the clinic of an unspecified physician, not at a pharmacy. On an unspecified date (reported as "several years ago"), the patient developed a fever, was hospitalized at an unspecified hospital for an unspecified length of time and received an unknown type of treatment. On an unknown date, the patient eventually died from an unknown cause. It was unknown if an autopsy was performed. At the time of this report, the causality assessment between the unidentified Merck hpv vaccine administered (name and lot number not provided) and the events, were not reported. The reporter considered the event of fever to be life threatening.

New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=830566&WAYBACKHISTORY=ON


Copyright © 2020 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166