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This is VAERS ID 734864

History of Changes from the VAERS Wayback Machine

First Appeared on 8/14/2019

VAERS ID: 734864
VAERS Form:2
Age:
Sex:Female
Location:Foreign
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:2018-01-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown      Purchased by: ??
Symptoms: No adverse event

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA0095075131801CAN009333

Write-up: This spontaneous report as received from a consumer refers to a 14 year old female patient. The patient''s medical history, concurrent conditions and concomitant medications were not reported. On an unknown date, the patient was vaccinated with GARDASIL (Dose, Lot # and expiry date was not reported) for prophylaxis. On an unknown date, the patient died. The cause of death was not reported. It was unknown if an autopsy was performed. The reporter considered death to be related to GARDASIL. Upon internal review, death was determined to be medically significant. Reported Cause(s) of Death: death.


Changed on 12/24/2020

VAERS ID: 734864 Before After
VAERS Form:2
Age:
Sex:Female
Location:Foreign
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:2018-01-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown      Purchased by: ??
Symptoms: No adverse event

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA0095075131801CAN009333

Write-up: This spontaneous report as received from a consumer refers to a 14 year old female patient. The patient''s medical history, concurrent conditions and concomitant medications were not reported. On an unknown date, the patient was vaccinated with GARDASIL (Dose, Lot # and expiry date was not reported) for prophylaxis. On an unknown date, the patient died. The cause of death was not reported. It was unknown if an autopsy was performed. The reporter considered death to be related to GARDASIL. Upon internal review, death was determined to be medically significant. Reported Cause(s) of Death: death.


Changed on 12/30/2020

VAERS ID: 734864 Before After
VAERS Form:2
Age:
Sex:Female
Location:Foreign
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:2018-01-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown      Purchased by: ??
Symptoms: No adverse event

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA0095075131801CAN009333

Write-up: This spontaneous report as received from a consumer refers to a 14 year old female patient. The patient''s medical history, concurrent conditions and concomitant medications were not reported. On an unknown date, the patient was vaccinated with GARDASIL (Dose, Lot # and expiry date was not reported) for prophylaxis. On an unknown date, the patient died. The cause of death was not reported. It was unknown if an autopsy was performed. The reporter considered death to be related to GARDASIL. Upon internal review, death was determined to be medically significant. Reported Cause(s) of Death: death.

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=734864&WAYBACKHISTORY=ON


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