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This is VAERS ID 425513

Case Details

VAERS ID: 425513 (history)  
Form: Version 1.0  
Age: 18.0  
Sex: Female  
Location: Idaho  
Vaccinated:2011-04-26
Onset:2011-04-28
   Days after vaccination:2
Submitted: 2011-04-29
   Days after onset:1
Entered: 2011-06-16
   Days after submission:48
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0886Z / 1 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1492Z / 2 RA / IM

Administered by: Private       Purchased by: Private
Symptoms: Completed suicide, Death
SMQs:, Suicide/self-injury (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2011-04-28
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? 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:
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

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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