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This is VAERS ID 297528

Case Details

VAERS ID: 297528 (history)  
Age: 12.0  
Gender: Female  
Location: Unknown  
Vaccinated:2007-09-15
Onset:2007-10-06
   Days after vaccination:21
Submitted: 2007-11-20
   Days after onset:45
Entered: 2007-11-23
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN

Administered by: Unknown       Purchased by: Unknown
Symptoms: Death
SMQs:

Life Threatening? Yes
Died? Yes
   Date died: 2007-10-06
   Days after onset: 0
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: WAES0711USA02619

Write-up: Information has been received from a physician''s assistant concerning a 12 year old female with no reported medical history who on approximately 15-SEP-2007 was vaccinated with Gardasil. It was noted that this was not where the vaccine was administered, rather they were the patient''s family physician. On 06-OCT-2007 the patient died in her sleep. No further information was provided. No lot number was given. Additional information has been requested.


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