National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 382971

History of Changes from the VAERS Wayback Machine

First Appeared on 4/7/2010

VAERS ID: 382971
VAERS Form:
Age:10.0
Sex:Female
Location:Foreign
Vaccinated:2009-10-09
Onset:2009-10-29
Submitted:2010-03-18
Entered:2010-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA050AG / 1 LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Death, Haemoglobin decreased, Headache, Malaria, Pyrexia, White blood cell count increased, Basophil percentage decreased, Neutrophil percentage increased, Monocyte percentage decreased, Eosinophil percentage, Blood smear test abnormal, Lymphocyte percentage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2009-10-30
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: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Basophils, 30Oct2009, 0%; Blood smear test, 30Oct2009, Positive; Eosinophils, 30Oct2009, 1%; Hemoglobin, 30Oct2009, 4g/dl; Lymphocytes, 30Oct2009, 28%; Monocytes, 30Oct2009, 0%; Neutrophils, 30Oct2009, 71%; White blood cell count, 30Oct2009
CDC 'Split Type': B0639818A

Write-up: This case was reported by a healthcare professional and described the occurrence of malaria in a 10-year-old female subject who was vaccinated with CERVARIX (GlaxoSmithKline). Previous and/or concurrent vaccination included CERVARIX; GlaxoSmithKline; intramuscular; left deltoid given on 2 September 2009. On 9 October 2009, the subject received 2nd dose of CERVARIX (intramuscular, left deltoid). No adverse event was reported during the observation period of 30 minutes after each dose of CERVARIX. The subject migrated to another village with her parents. She was in good condition and doing well. On 29 October 2009, 1 month after vaccination with the 2nd dose of CERVARIX, the subject experienced severe headache and fever. She visited a private local clinic for treatment as an outdoor patient. The subject was given an injection of an unspecified drug in the right upper arm by the physician. Malaria was suspected and a blood test was prescribed. Unspecified medication was also provided by the physician. On 30 October 2009, the subject was brought to the hospital in critical condition. The laboratory test on blood showed low hemoglobin level 4g/dl which is only 27.58% of a normal level, white blood cells 46200/mm3 with 71% neutrophils, 28% lymphocytes, 1% eosinophils, 0% monocytes and 0% basophils. The thin and thick blood smear analysis revealed many rings of trophozoites and schizont of plasmodium Vivax. The diagnosis of malaria was made. The subject was sent to the community health center where a treatment was started. Around 1 hour later, the subject was declared dead. The subject died on 30 October 2009 from malaria. An autopsy was not performed.


Changed on 1/4/2011

VAERS ID: 382971 Before After
VAERS Form:
Age:10.0
Sex:Female
Location:Foreign
Vaccinated:2009-10-09
Onset:2009-10-29
Submitted:2010-03-18
Entered:2010-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA050AG / 1 LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Death, Haemoglobin decreased, Headache, Malaria, Pyrexia, White blood cell count increased, Basophil percentage decreased, Neutrophil percentage increased, Monocyte percentage decreased, Eosinophil percentage, Blood smear test abnormal, Lymphocyte percentage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2009-10-30
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: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Basophils, 30Oct2009, 0%; Blood smear test, 30Oct2009, Positive; Eosinophils, 30Oct2009, 1%; Hemoglobin, 30Oct2009, 4g/dl; Lymphocytes, 30Oct2009, 28%; Monocytes, 30Oct2009, 0%; Neutrophils, 30Oct2009, 71%; White blood cell count, 30Oct2009 30Oct2009, 46200/mm3
CDC 'Split Type': B0639818A

Write-up: This case was reported by a healthcare professional and described the occurrence of malaria in a 10-year-old female subject who was vaccinated with CERVARIX (GlaxoSmithKline). Previous and/or concurrent vaccination included CERVARIX; GlaxoSmithKline; intramuscular; left deltoid given on 2 September 2009. On 9 October 2009, the subject received 2nd dose of CERVARIX (intramuscular, left deltoid). No adverse event was reported during the observation period of 30 minutes after each dose of CERVARIX. The subject migrated to another village with her parents. She was in good condition and doing well. On 29 October 2009, 1 month after vaccination with the 2nd dose of CERVARIX, the subject experienced severe headache and fever. She visited a private local clinic for treatment as an outdoor patient. The subject was given an injection of an unspecified drug in the right upper arm by the physician. Malaria was suspected and a blood test was prescribed. Unspecified medication was also provided by the physician. On 30 October 2009, the subject was brought to the hospital in critical condition. The laboratory test on blood showed low hemoglobin level 4g/dl which is only 27.58% of a normal level, white blood cells 46200/mm3 with 71% neutrophils, 28% lymphocytes, 1% eosinophils, 0% monocytes and 0% basophils. The thin and thick blood smear analysis revealed many rings of trophozoites and schizont of plasmodium Vivax. The diagnosis of malaria was made. The subject was sent to the community health center where a treatment was started. Around 1 hour later, the subject was declared dead. The subject died on 30 October 2009 from malaria. An autopsy was not performed.


Changed on 9/14/2017

VAERS ID: 382971 Before After
VAERS Form:(blank) 1
Age:10.0
Sex:Female
Location:Foreign
Vaccinated:2009-10-09
Onset:2009-10-29
Submitted:2010-03-18
Entered:2010-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA050AG / 1 2 LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Death, Haemoglobin decreased, Headache, Malaria, Pyrexia, White blood cell count increased, Basophil percentage decreased, Neutrophil percentage increased, Monocyte percentage decreased, Eosinophil percentage, Blood smear test abnormal, Lymphocyte percentage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2009-10-30
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: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Basophils, 30Oct2009, 0%; Blood smear test, 30Oct2009, Positive; Eosinophils, 30Oct2009, 1%; Hemoglobin, 30Oct2009, 4g/dl; Lymphocytes, 30Oct2009, 28%; Monocytes, 30Oct2009, 0%; Neutrophils, 30Oct2009, 71%; White blood cell count, 30Oct2009, 46200/mm3
CDC 'Split Type': B0639818A

Write-up: This case was reported by a healthcare professional and described the occurrence of malaria in a 10-year-old female subject who was vaccinated with CERVARIX (GlaxoSmithKline). Previous and/or concurrent vaccination included CERVARIX; GlaxoSmithKline; intramuscular; left deltoid given on 2 September 2009. On 9 October 2009, the subject received 2nd dose of CERVARIX (intramuscular, left deltoid). No adverse event was reported during the observation period of 30 minutes after each dose of CERVARIX. The subject migrated to another village with her parents. She was in good condition and doing well. On 29 October 2009, 1 month after vaccination with the 2nd dose of CERVARIX, the subject experienced severe headache and fever. She visited a private local clinic for treatment as an outdoor patient. The subject was given an injection of an unspecified drug in the right upper arm by the physician. Malaria was suspected and a blood test was prescribed. Unspecified medication was also provided by the physician. On 30 October 2009, the subject was brought to the hospital in critical condition. The laboratory test on blood showed low hemoglobin level 4g/dl which is only 27.58% of a normal level, white blood cells 46200/mm3 with 71% neutrophils, 28% lymphocytes, 1% eosinophils, 0% monocytes and 0% basophils. The thin and thick blood smear analysis revealed many rings of trophozoites and schizont of plasmodium Vivax. The diagnosis of malaria was made. The subject was sent to the community health center where a treatment was started. Around 1 hour later, the subject was declared dead. The subject died on 30 October 2009 from malaria. An autopsy was not performed.


Changed on 2/14/2018

VAERS ID: 382971 Before After
VAERS Form:1
Age:10.0
Sex:Female
Location:Foreign
Vaccinated:2009-10-09
Onset:2009-10-29
Submitted:2010-03-18
Entered:2010-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA050AG / 2 LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Death, Haemoglobin decreased, Headache, Malaria, Pyrexia, White blood cell count increased, Basophil percentage decreased, Neutrophil percentage increased, Monocyte percentage decreased, Eosinophil percentage, Blood smear test abnormal, Lymphocyte percentage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2009-10-30
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: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Basophils, 30Oct2009, 0%; Blood smear test, 30Oct2009, Positive; Eosinophils, 30Oct2009, 1%; Hemoglobin, 30Oct2009, 4g/dl; Lymphocytes, 30Oct2009, 28%; Monocytes, 30Oct2009, 0%; Neutrophils, 30Oct2009, 71%; White blood cell count, 30Oct2009, 46200/mm3
CDC 'Split Type': B0639818A

Write-up: This case was reported by a healthcare professional and described the occurrence of malaria in a 10-year-old female subject who was vaccinated with CERVARIX (GlaxoSmithKline). Previous and/or concurrent vaccination included CERVARIX; GlaxoSmithKline; intramuscular; left deltoid given on 2 September 2009. On 9 October 2009, the subject received 2nd dose of CERVARIX (intramuscular, left deltoid). No adverse event was reported during the observation period of 30 minutes after each dose of CERVARIX. The subject migrated to another village with her parents. She was in good condition and doing well. On 29 October 2009, 1 month after vaccination with the 2nd dose of CERVARIX, the subject experienced severe headache and fever. She visited a private local clinic for treatment as an outdoor patient. The subject was given an injection of an unspecified drug in the right upper arm by the physician. Malaria was suspected and a blood test was prescribed. Unspecified medication was also provided by the physician. On 30 October 2009, the subject was brought to the hospital in critical condition. The laboratory test on blood showed low hemoglobin level 4g/dl which is only 27.58% of a normal level, white blood cells 46200/mm3 with 71% neutrophils, 28% lymphocytes, 1% eosinophils, 0% monocytes and 0% basophils. The thin and thick blood smear analysis revealed many rings of trophozoites and schizont of plasmodium Vivax. The diagnosis of malaria was made. The subject was sent to the community health center where a treatment was started. Around 1 hour later, the subject was declared dead. The subject died on 30 October 2009 from malaria. An autopsy was not performed.


Changed on 6/14/2018

VAERS ID: 382971 Before After
VAERS Form:1
Age:10.0
Sex:Female
Location:Foreign
Vaccinated:2009-10-09
Onset:2009-10-29
Submitted:2010-03-18
Entered:2010-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA050AG / 2 LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Death, Haemoglobin decreased, Headache, Malaria, Pyrexia, White blood cell count increased, Basophil percentage decreased, Neutrophil percentage increased, Monocyte percentage decreased, Eosinophil percentage, Blood smear test abnormal, Lymphocyte percentage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2009-10-30
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: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Basophils, 30Oct2009, 0%; Blood smear test, 30Oct2009, Positive; Eosinophils, 30Oct2009, 1%; Hemoglobin, 30Oct2009, 4g/dl; Lymphocytes, 30Oct2009, 28%; Monocytes, 30Oct2009, 0%; Neutrophils, 30Oct2009, 71%; White blood cell count, 30Oct2009, 46200/mm3
CDC 'Split Type': B0639818A

Write-up: This case was reported by a healthcare professional and described the occurrence of malaria in a 10-year-old female subject who was vaccinated with CERVARIX (GlaxoSmithKline). Previous and/or concurrent vaccination included CERVARIX; GlaxoSmithKline; intramuscular; left deltoid given on 2 September 2009. On 9 October 2009, the subject received 2nd dose of CERVARIX (intramuscular, left deltoid). No adverse event was reported during the observation period of 30 minutes after each dose of CERVARIX. The subject migrated to another village with her parents. She was in good condition and doing well. On 29 October 2009, 1 month after vaccination with the 2nd dose of CERVARIX, the subject experienced severe headache and fever. She visited a private local clinic for treatment as an outdoor patient. The subject was given an injection of an unspecified drug in the right upper arm by the physician. Malaria was suspected and a blood test was prescribed. Unspecified medication was also provided by the physician. On 30 October 2009, the subject was brought to the hospital in critical condition. The laboratory test on blood showed low hemoglobin level 4g/dl which is only 27.58% of a normal level, white blood cells 46200/mm3 with 71% neutrophils, 28% lymphocytes, 1% eosinophils, 0% monocytes and 0% basophils. The thin and thick blood smear analysis revealed many rings of trophozoites and schizont of plasmodium Vivax. The diagnosis of malaria was made. The subject was sent to the community health center where a treatment was started. Around 1 hour later, the subject was declared dead. The subject died on 30 October 2009 from malaria. An autopsy was not performed.


Changed on 8/14/2018

VAERS ID: 382971 Before After
VAERS Form:1
Age:10.0
Sex:Female
Location:Foreign
Vaccinated:2009-10-09
Onset:2009-10-29
Submitted:2010-03-18
Entered:2010-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA050AG / 2 LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Death, Haemoglobin decreased, Headache, Malaria, Pyrexia, White blood cell count increased, Basophil percentage decreased, Neutrophil percentage increased, Monocyte percentage decreased, Eosinophil percentage, Blood smear test abnormal, Lymphocyte percentage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2009-10-30
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: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Basophils, 30Oct2009, 0%; Blood smear test, 30Oct2009, Positive; Eosinophils, 30Oct2009, 1%; Hemoglobin, 30Oct2009, 4g/dl; Lymphocytes, 30Oct2009, 28%; Monocytes, 30Oct2009, 0%; Neutrophils, 30Oct2009, 71%; White blood cell count, 30Oct2009, 46200/mm3
CDC 'Split Type': B0639818A

Write-up: This case was reported by a healthcare professional and described the occurrence of malaria in a 10-year-old female subject who was vaccinated with CERVARIX (GlaxoSmithKline). Previous and/or concurrent vaccination included CERVARIX; GlaxoSmithKline; intramuscular; left deltoid given on 2 September 2009. On 9 October 2009, the subject received 2nd dose of CERVARIX (intramuscular, left deltoid). No adverse event was reported during the observation period of 30 minutes after each dose of CERVARIX. The subject migrated to another village with her parents. She was in good condition and doing well. On 29 October 2009, 1 month after vaccination with the 2nd dose of CERVARIX, the subject experienced severe headache and fever. She visited a private local clinic for treatment as an outdoor patient. The subject was given an injection of an unspecified drug in the right upper arm by the physician. Malaria was suspected and a blood test was prescribed. Unspecified medication was also provided by the physician. On 30 October 2009, the subject was brought to the hospital in critical condition. The laboratory test on blood showed low hemoglobin level 4g/dl which is only 27.58% of a normal level, white blood cells 46200/mm3 with 71% neutrophils, 28% lymphocytes, 1% eosinophils, 0% monocytes and 0% basophils. The thin and thick blood smear analysis revealed many rings of trophozoites and schizont of plasmodium Vivax. The diagnosis of malaria was made. The subject was sent to the community health center where a treatment was started. Around 1 hour later, the subject was declared dead. The subject died on 30 October 2009 from malaria. An autopsy was not performed.


Changed on 9/14/2018

VAERS ID: 382971 Before After
VAERS Form:1
Age:10.0
Sex:Female
Location:Foreign
Vaccinated:2009-10-09
Onset:2009-10-29
Submitted:2010-03-18
Entered:2010-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA050AG / 2 LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Death, Haemoglobin decreased, Headache, Malaria, Pyrexia, White blood cell count increased, Basophil percentage decreased, Neutrophil percentage increased, Monocyte percentage decreased, Eosinophil percentage, Blood smear test abnormal, Lymphocyte percentage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2009-10-30
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: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Basophils, 30Oct2009, 0%; Blood smear test, 30Oct2009, Positive; Eosinophils, 30Oct2009, 1%; Hemoglobin, 30Oct2009, 4g/dl; Lymphocytes, 30Oct2009, 28%; Monocytes, 30Oct2009, 0%; Neutrophils, 30Oct2009, 71%; White blood cell count, 30Oct2009, 46200/mm3
CDC 'Split Type': B0639818A

Write-up: This case was reported by a healthcare professional and described the occurrence of malaria in a 10-year-old female subject who was vaccinated with CERVARIX (GlaxoSmithKline). Previous and/or concurrent vaccination included CERVARIX; GlaxoSmithKline; intramuscular; left deltoid given on 2 September 2009. On 9 October 2009, the subject received 2nd dose of CERVARIX (intramuscular, left deltoid). No adverse event was reported during the observation period of 30 minutes after each dose of CERVARIX. The subject migrated to another village with her parents. She was in good condition and doing well. On 29 October 2009, 1 month after vaccination with the 2nd dose of CERVARIX, the subject experienced severe headache and fever. She visited a private local clinic for treatment as an outdoor patient. The subject was given an injection of an unspecified drug in the right upper arm by the physician. Malaria was suspected and a blood test was prescribed. Unspecified medication was also provided by the physician. On 30 October 2009, the subject was brought to the hospital in critical condition. The laboratory test on blood showed low hemoglobin level 4g/dl which is only 27.58% of a normal level, white blood cells 46200/mm3 with 71% neutrophils, 28% lymphocytes, 1% eosinophils, 0% monocytes and 0% basophils. The thin and thick blood smear analysis revealed many rings of trophozoites and schizont of plasmodium Vivax. The diagnosis of malaria was made. The subject was sent to the community health center where a treatment was started. Around 1 hour later, the subject was declared dead. The subject died on 30 October 2009 from malaria. An autopsy was not performed.


Changed on 10/14/2018

VAERS ID: 382971 Before After
VAERS Form:1
Age:10.0
Sex:Female
Location:Foreign
Vaccinated:2009-10-09
Onset:2009-10-29
Submitted:2010-03-18
Entered:2010-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA050AG / 2 LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Death, Haemoglobin decreased, Headache, Malaria, Pyrexia, White blood cell count increased, Basophil percentage decreased, Neutrophil percentage increased, Monocyte percentage decreased, Eosinophil percentage, Blood smear test abnormal, Lymphocyte percentage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2009-10-30
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: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Basophils, 30Oct2009, 0%; Blood smear test, 30Oct2009, Positive; Eosinophils, 30Oct2009, 1%; Hemoglobin, 30Oct2009, 4g/dl; Lymphocytes, 30Oct2009, 28%; Monocytes, 30Oct2009, 0%; Neutrophils, 30Oct2009, 71%; White blood cell count, 30Oct2009, 46200/mm3
CDC 'Split Type': B0639818A

Write-up: This case was reported by a healthcare professional and described the occurrence of malaria in a 10-year-old female subject who was vaccinated with CERVARIX (GlaxoSmithKline). Previous and/or concurrent vaccination included CERVARIX; GlaxoSmithKline; intramuscular; left deltoid given on 2 September 2009. On 9 October 2009, the subject received 2nd dose of CERVARIX (intramuscular, left deltoid). No adverse event was reported during the observation period of 30 minutes after each dose of CERVARIX. The subject migrated to another village with her parents. She was in good condition and doing well. On 29 October 2009, 1 month after vaccination with the 2nd dose of CERVARIX, the subject experienced severe headache and fever. She visited a private local clinic for treatment as an outdoor patient. The subject was given an injection of an unspecified drug in the right upper arm by the physician. Malaria was suspected and a blood test was prescribed. Unspecified medication was also provided by the physician. On 30 October 2009, the subject was brought to the hospital in critical condition. The laboratory test on blood showed low hemoglobin level 4g/dl which is only 27.58% of a normal level, white blood cells 46200/mm3 with 71% neutrophils, 28% lymphocytes, 1% eosinophils, 0% monocytes and 0% basophils. The thin and thick blood smear analysis revealed many rings of trophozoites and schizont of plasmodium Vivax. The diagnosis of malaria was made. The subject was sent to the community health center where a treatment was started. Around 1 hour later, the subject was declared dead. The subject died on 30 October 2009 from malaria. An autopsy was not performed.

New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=382971&WAYBACKHISTORY=ON


Copyright © 2019 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166