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From the 1/7/2022 release of VAERS data:

This is VAERS ID 356938

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Case Details

VAERS ID: 356938 (history)  
Form: Version 1.0  
Age: 19.0  
Sex: Female  
Location: Oklahoma  
   Days after vaccination:53
Submitted: 2009-09-10
   Days after onset:363
Entered: 2009-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 17400 / 3 LA / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Chest pain, Death, Dizziness, Dyspnoea, Fatigue, Feeling cold, Headache, Muscle spasms, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Dystonia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2008-09-12
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: None~ ()~~0.00~Patient
Other Medications: Yaz until 3/17/08. Femcon beginning 3/17/08. Anaprox as needed.
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None. I do have copies of all medical history from 01/08/2004 to the time of her death that I can provide if needed. The Medical Examiners office will have tissue samples until 4/2010.
CDC Split Type:

Write-up: Headache, Nausea, dizziness, chilling, tiredness, shortness of breath, complained of chest plain, severe cramps. 9/14/09 Received vaccine & PCP medical records which reveal patient seen 12/5/07 & 2/27/08 with sore throat, fever, chills, fatigue, body aches, productive cough w/yellow sputum & HA. Dx both times w/acute bronchitis & tx w/antibiotics & cough syrup. 9/25/09 Autopsy report received DOD 09/12/2008. Acute Cardiac Arrhythmia of Unknown Etiology. Addtional information abstracted: Heart with focal microscopic ischemic changes, pulmonary congestion and edema. Rare petechiae: conjunctival, periorbital and laryngeal. Resuscitation related sternal fracture.

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