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| VAERS ID: | 417137 (history) | Vaccinated: | 2011-01-04 | | Age: | 17.0 | Onset: | 2011-02-02, Days after vaccination: 29 | | Gender: | Female | Submitted: | 2011-02-08, Days after onset: 6 | | Location: | Tennessee | Entered: | 2011-02-18, Days after submission: 10 | |
| Life Threatening? No |
Died? Yes Date died: 2011-02-02 Days after onset: 0 |
| Permanent Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Previous Vaccinations: | | Other Medications: NORINYL | | Current Illness: none | | Preexisting Conditions: Hay fever; Animal fur | | Diagnostic Lab Data: | | CDC 'Split Type': TN1101 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4: HPV (GARDASIL) | MERCK & CO. INC. | 0096Z | 1 | IM | RA | | MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) | SANOFI PASTEUR | U3432AA | 0 | IM | LA | |
| Administered by: Public Purchased by: Public | Symptoms: Blood culture positive,
CSF culture positive,
Culture throat positive,
Death,
Dehydration,
Diarrhoea,
Disseminated intravascular coagulation,
Excoriation,
Nausea,
Obesity,
Oropharyngeal pain,
Pleural effusion,
Pulmonary haemorrhage,
Streptococcal bacteraemia,
Streptococcus test positive,
Toxic shock syndrome SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Systemic lupus erythematosus (broad), Toxic-septic shock conditions (narrow), Pseudomembranous colitis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Accidents and injuries (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)
| | Write-up: Patient deceased within 30 days of vaccine administration. |
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| VAERS ID: | 421582 (history) | Vaccinated: | 2010-11-01 | | Age: | 17.0 | Onset: | 2010-11-01, Days after vaccination: 0 | | Gender: | Male | Submitted: | 2011-04-21, Days after onset: 171 | | Location: | Unknown | Entered: | 2011-04-22, Days after submission: 1 | |
| Life Threatening? Yes |
Died? Yes Date died: 0000-00-00 |
| Permanent Disability? Yes |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Previous Vaccinations: | | Other Medications: Unknown | | Current Illness: | | Preexisting Conditions: Unknown | | Diagnostic Lab Data: Unknown | | CDC 'Split Type': WAES1104USA02226 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4: HPV (GARDASIL) | MERCK & CO. INC. | | | UN | UN | |
| Administered by: Other Purchased by: Other | Symptoms: Death,
Sudden cardiac death SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Cardiomyopathy (broad)
| | Write-up: Information has been received from a nurse practitioner concerning a patient''s nephew, a 17 year old male consumer who she "thought" was vaccinated with a dose of GARDASIL (lot number not provided) in November 2010. The nurse practitioner stated that two weeks after the patient received the dose of GARDASIL, approximately November 2010 (also reported as "two weeks ago" on approximately 01-APR-2011), the patient died of sudden cardiac death on the lacrosse field. Unspecified medical treatment was given. It was unspecified if any lab diagnostic test were performed. The cause of death was sudden cardiac death. Sudden cardiac death was considered to be immediately life-threatening and disabling by the reporting nurse practitioner. Additional information has been requested. |
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| VAERS ID: | 425513 (history) | Vaccinated: | 2011-04-26 | | Age: | 18.0 | Onset: | 2011-04-28, Days after vaccination: 2 | | Gender: | Female | Submitted: | 2011-04-29, Days after onset: 1 | | Location: | Idaho | Entered: | 2011-06-16, Days after submission: 48 | |
| Life Threatening? No |
Died? Yes Date died: 2011-04-28 Days after onset: 0 |
| Permanent Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Previous Vaccinations: | | Other Medications: ORTHO CYCLEN | | Current Illness: (1) Depression/chronic; (2) ADHD; (3) acne severe | | Preexisting Conditions: | | Diagnostic Lab Data: None | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4: HPV (GARDASIL) | MERCK & CO. INC. | 0886Z | 0 | IM | LA | | VARCEL: VARICELLA (VARIVAX) | MERCK & CO. INC. | 1492Z | 1 | IM | RA | |
| Administered by: Private Purchased by: Private | Symptoms: Completed suicide,
Death SMQs:, Suicide/self-injury (narrow)
| | Write-up: None known -suicidal ideation denied at visit 4/26 - known chronic depression she elected to stop her medications when she turned 18. Committed suicide 04/28/11. Hung herself. |
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| VAERS ID: | 425598 (history) | Vaccinated: | 0000-00-00 | | Age: | | Onset: | 0000-00-00 | | Gender: | Female | Submitted: | 2011-06-16 | | Location: | Unknown | Entered: | 2011-06-17, Days after submission: 1 | |
| Life Threatening? No |
Died? Yes Date died: 0000-00-00 |
| Permanent Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Previous Vaccinations: | | Other Medications: Unknown | | Current Illness: | | Preexisting Conditions: Unknown | | Diagnostic Lab Data: Unknown | | CDC 'Split Type': WAES1106USA01652 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4: HPV (GARDASIL) | MERCK & CO. INC. | | | UN | UN | |
| Administered by: Other Purchased by: Other | Symptoms: Death,
Thrombosis SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad)
| | Write-up: A consumer reported that he/she read an internet concerning a female who on an unspecified date was vaccinated with a dose of GARDASIL (lot # , dose and route not reported). On an unspecified date, the patient died of "clot blood" eight hours after vaccination. This is one of several reports from the same source. No further information is available. |
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| VAERS ID: | 425680 (history) | Vaccinated: | 2007-06-01 | | Age: | 17.0 | Onset: | 2007-06-01, Days after vaccination: 0 | | Gender: | Female | Submitted: | 2011-06-17, Days after onset: 1477 | | Location: | Unknown | Entered: | 2011-06-20, Days after submission: 3 | |
| Life Threatening? No |
Died? Yes Date died: 0000-00-00 |
| Permanent Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Previous Vaccinations: | | Other Medications: Unknown | | Current Illness: | | Preexisting Conditions: Unknown | | Diagnostic Lab Data: Unknown | | CDC 'Split Type': WAES1106USA01650 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4: HPV (GARDASIL) | MERCK & CO. INC. | | 0 | UN | UN | |
| Administered by: Other Purchased by: Other | Symptoms: Death,
Loss of consciousness,
Resuscitation SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
| | Write-up: A consumer reported that he/she obtained the information from internet concerning a 17 years old woman who in June 2007 was vaccinated the first dose of GARDASIL. In the afternoon of the same day, in June 2007, the patient was found unconscious (without signs of life) by her mother. The doctor from the emergency crew attempted resuscitation, but without success. The cause of death was unspecified. This is one of several reports received from the same source. No further information is available. |
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| VAERS ID: | 429007 (history) | Vaccinated: | 0000-00-00 | | Age: | | Onset: | 0000-00-00 | | Gender: | Female | Submitted: | 2011-08-05 | | Location: | Unknown | Entered: | 2011-08-08, Days after submission: 3 | |
| Life Threatening? No |
Died? Yes Date died: 0000-00-00 |
| Permanent Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Previous Vaccinations: | | Other Medications: Unknown | | Current Illness: | | Preexisting Conditions: Unknown | | Diagnostic Lab Data: Unknown | | CDC 'Split Type': WAES1108USA00348 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4: HPV (GARDASIL) | MERCK & CO. INC. | | | UN | UN | |
| Administered by: Other Purchased by: Other | Symptoms: Death SMQs:
| | Write-up: Information has been received from a consumer concerning her daughter who was vaccinated with GARDASIL. The consumer reported that he had nothing to live for because GARDASIL killed his daughter. It was unknown if the patient sought medical attention. No further information is available. |
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| VAERS ID: | 429121 (history) | Vaccinated: | 0000-00-00 | | Age: | | Onset: | 0000-00-00 | | Gender: | Unknown | Submitted: | 2011-08-08 | | Location: | Unknown | Entered: | 2011-08-09, Days after submission: 1 | |
| Life Threatening? No |
| Died? No |
| Permanent Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Previous Vaccinations: | | Other Medications: Unknown | | Current Illness: | | Preexisting Conditions: Unknown | | Diagnostic Lab Data: Unknown | | CDC 'Split Type': WAES1107USA04018B1 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4: HPV (GARDASIL) | MERCK & CO. INC. | | | UN | UN | |
| Administered by: Other Purchased by: Other | Symptoms: Death,
Drug exposure via breast milk SMQs:, Neonatal exposures via breast milk (narrow)
| | Write-up: Information has been received from a Doctor of science who authored an article published in journal. The author reported that a breast-feeding mother on unspecified date was vaccinated with GARDASIL and that shortly following the vaccination her baby died. The author stated that both mother and child were completely healthy prior to the vaccination. The mother''s experience has been captured in WAES 1107USA04018. No further information is available. |
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| VAERS ID: | 430780 (history) | Vaccinated: | 2011-03-28 | | Age: | 14.0 | Onset: | 2011-04-11, Days after vaccination: 14 | | Gender: | Female | Submitted: | 2011-08-23, Days after onset: 134 | | Location: | California | Entered: | 2011-08-23 | |
| Life Threatening? No |
Died? Yes Date died: 2011-04-11 Days after onset: 0 |
| Permanent Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Previous Vaccinations: | | Other Medications: | | Current Illness: | | Preexisting Conditions: Mildly overweight; concern for idiopathic scoliosis | | Diagnostic Lab Data: Autopsy, including microscopy slides. Heart blood culture showed alpha streptococcus (not Strep. pneumoniae, not enterococcus sp., not Strep. bovis). Femoral blood and vitreous humor samples showed no drugs on complete drug screen. Vitreous panel (Glucose - 32 mg/dL, Sodium - 137 mmol/L, Potassium - 15.2 mmol/L, Chloride - 124 mmol/L, Urea Nitrogen 13 mg/dL and Creatinine - 1.3 mg/dL) | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | FLU: INFLUENZA (SEASONAL) (FLUZONE) | SANOFI PASTEUR | U3741AA | 0 | UN | LA | | HPV4: HPV (GARDASIL) | MERCK & CO. INC. | 0565Z | 2 | UN | LA | |
| Administered by: Public Purchased by: Public | Symptoms: Arrhythmia,
Autopsy,
Blood culture positive,
Body fluid analysis,
Cardiac failure,
Cardiomyopathy,
Death,
Drug screen negative,
Microscopy,
Streptococcus test positive,
Sudden cardiac death SMQs:, Torsade de pointes/QT prolongation (broad), Cardiac failure (narrow), Arrhythmia related investigations, signs and symptoms (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Cardiomyopathy (narrow), Cardiac arrhythmia terms, nonspecific (narrow)
| | Write-up: Found dead in bed in a.m. by family. Pathologist stated cause of death as consistent with cardiac insufficiency, due to cardiac arrhythmia, due to probable early cardiomyopathy. Child Death Review Team felt this death was consistent with a diagnosis of sudden cardiac death. |
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| VAERS ID: | 437735 (history) | Vaccinated: | 2011-01-07 | | Age: | 18.0 | Onset: | 2011-04-01, Days after vaccination: 84 | | Gender: | Female | Submitted: | 2011-10-11, Days after onset: 193 | | Location: | Massachusetts | Entered: | 2011-10-11 | |
| Life Threatening? No |
Died? Yes Date died: 2011-07-06 Days after onset: 96 |
| Permanent Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Previous Vaccinations: | | Other Medications: none | | Current Illness: | | Preexisting Conditions: Immune thrombocytopenic purpura, diagnosed in 1995 and in remission from 2004 to 2011 following treatment with Rituximab in 2004. | | Diagnostic Lab Data: Petechiae and ecchymoses noted by patient and family in early April (exact date not known). CBC on 04/26/2011 included platelet count 5000; WBC 5.4 with normal differential, Hgb 12.8, Hct 37.2, MCV 87.9; normal RBC morphology. | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4: HPV (GARDASIL) | MERCK & CO. INC. | | 1 | IM | | |
| Administered by: Unknown Purchased by: Other | Symptoms: Condition aggravated,
Death,
Differential white blood cell count normal,
Ecchymosis,
Haematocrit normal,
Haemoglobin normal,
Haemorrhage intracranial,
Idiopathic thrombocytopenic purpura,
Mean cell volume normal,
Petechiae,
Platelet count decreased,
Red blood cell morphology normal,
White blood cell count normal SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Haemorrhagic cerebrovascular conditions (narrow)
| | Write-up: Relapse of ITP: 18 year-old female with immune thrombocytopenic purpura, diagnosed in 1995 and in remission from 2004 to 2011 following treatment with Rituximab. Relapse in early April, 2011, followed administration of Gardasil vaccine on 10-26-10 and 1-7-11. Relapse of ITP led eventually to death from intracranial hemorrhage on 07/06/2011. |
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| VAERS ID: | 437999 (history) | Vaccinated: | 2011-07-22 | | Age: | 18.0 | Onset: | 2011-07-27, Days after vaccination: 5 | | Gender: | Male | Submitted: | 2011-10-12, Days after onset: 77 | | Location: | Ohio | Entered: | 2011-10-13, Days after submission: 1 | |
| Life Threatening? No |
Died? Yes Date died: 2011-07-27 Days after onset: 0 |
| Permanent Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Previous Vaccinations: | | Other Medications: SEPTRA | | Current Illness: Acne | | Preexisting Conditions: | | Diagnostic Lab Data: diagnostic laboratory, ?/?/11, toxic screen indicated that there were no medications involved in the patient''s death. | | CDC 'Split Type': WAES1110USA00917 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HEPA: HEP A (VAQTA) | MERCK & CO. INC. | 0126AA | | UN | UN | | HPV4: HPV (GARDASIL) | MERCK & CO. INC. | 0841AA | 1 | UN | UN | |
| Administered by: Other Purchased by: Other | Symptoms: Asphyxia,
Completed suicide,
Death,
Drug screen negative,
Toxicologic test normal SMQs:, Suicide/self-injury (narrow), Acute central respiratory depression (broad), Hostility/aggression (broad)
| | Write-up: Information has been received from a physician concerning an 18 year old male patient with acne and no drug allergy or reaction who on 16-MAY-2011 was vaccinated with the first dose of GARDASIL (Lot number 668554/0306AA; Expired date: 10-MAY-2013) and a dose of VAQTA (Lot number: 670377/0126AA; Expired date: 07-DEC-2013, dose in series unknown). On 22-JUL-2011, the patient received the second dose of GARDASIL (Lot number 668262/0841AA; Expired date: 18-APR-2013). Concomitant therapy included SEPTRA. Follow up phone call from the physician was received. The physician reported that the patient had no medical history. The last time he saw the patient was on 22-JUL-2011, when the patient received his second dose of GARDASIL. The physician also reported that there was no indication from the patient that he was troubled. On 27-JUL-2011 the patient committed suicide. The cause of death was asphyxiation by hanging. The death report that the physician received was that the patient had a normal examination. The Toxic screen indicated that there were no medications involved in the patient''s death. The patient''s mother had asked the physician if GARDASIL could have caused her son to commit suicide. The physician reported to the patient''s mother that he did not feel that GARDASIL was the cause of her son''s suicide. The physician stated that he was not aware of any reported deaths by suicide that were related to GARDASIL. Lot checks have been initiated for 668554/0306AA, 668262/0841AA for GARDASIL and 670377/0126AA for VAQTA. Additional information has been requested. |
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