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This is VAERS ID 453010

Case Details

VAERS ID: 453010 (history)  
Form: Version 1.0  
Age: 16.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2012-03-20
Onset:2012-03-29
   Days after vaccination:9
Submitted: 2012-04-04
   Days after onset:6
Entered: 2012-04-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0692AA / 2 RA / IM

Administered by: Private       Purchased by: Public
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2012-03-29
   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: Loestrin 1/20mg one daily. Cetraxal 0.2% solution 2 drops bid for 7 days
Current Illness: none
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Undetermined cause death occurred nine days after 2nd injection of Gardasil. 1st dose on 01/31/2012.


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