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This is VAERS ID 767887

History of Changes from the VAERS Wayback Machine

First Appeared on 1/14/2019

VAERS ID: 767887
VAERS Form:2
Age:10.0
Sex:Female
Location:Foreign
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:2018-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK - / UN

Administered by: Unknown      Purchased by: ??
Symptoms: Death, Depressed level of consciousness, Vomiting

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': ID0095075131808IDN010115

Write-up: Information has been received from a business partner representative referring to a 10 year old female patient. The patient''s concurrent condition, medical history and concomitant medication were unknown. On an unknown date (reported as 08-AUG-????) the patient was vaccinated with GARDASIL (dose, route, batch/ lot # and expiration date were unknown) for prophylaxis. On an unknown date (reported as 08-AUG-????), the patient experienced vomiting, decrease of consciousness and got hospitalized. On an unknown date (reported as 14-AUG-????), the patient passed away. The cause of death was not provided. It was unknown if autopsy was performed. The causality assessment was not provided by reporter. Reported Cause(s) of Death: unknown cause of death.


Changed on 12/24/2020

VAERS ID: 767887 Before After
VAERS Form:2
Age:10.0
Sex:Female
Location:Foreign
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:2018-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK - / UN

Administered by: Unknown      Purchased by: ??
Symptoms: Death, Depressed level of consciousness, Vomiting

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': ID0095075131808IDN010115

Write-up: Information has been received from a business partner representative referring to a 10 year old female patient. The patient''s concurrent condition, medical history and concomitant medication were unknown. On an unknown date (reported as 08-AUG-????) the patient was vaccinated with GARDASIL (dose, route, batch/ lot # and expiration date were unknown) for prophylaxis. On an unknown date (reported as 08-AUG-????), the patient experienced vomiting, decrease of consciousness and got hospitalized. On an unknown date (reported as 14-AUG-????), the patient passed away. The cause of death was not provided. It was unknown if autopsy was performed. The causality assessment was not provided by reporter. Reported Cause(s) of Death: unknown cause of death.


Changed on 12/30/2020

VAERS ID: 767887 Before After
VAERS Form:2
Age:10.0
Sex:Female
Location:Foreign
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:2018-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK - / UN

Administered by: Unknown      Purchased by: ??
Symptoms: Death, Depressed level of consciousness, Vomiting

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': ID0095075131808IDN010115

Write-up: Information has been received from a business partner representative referring to a 10 year old female patient. The patient''s concurrent condition, medical history and concomitant medication were unknown. On an unknown date (reported as 08-AUG-????) the patient was vaccinated with GARDASIL (dose, route, batch/ lot # and expiration date were unknown) for prophylaxis. On an unknown date (reported as 08-AUG-????), the patient experienced vomiting, decrease of consciousness and got hospitalized. On an unknown date (reported as 14-AUG-????), the patient passed away. The cause of death was not provided. It was unknown if autopsy was performed. The causality assessment was not provided by reporter. Reported Cause(s) of Death: unknown cause of death.

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