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This is VAERS ID 492468

Case Details

VAERS ID: 492468 (history)  
Form: Version 1.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2013-05-24
Entered: 2013-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: WAES1305USA013443

Write-up: This spontaneous report as received from a female consumer via company representative who refers to her niece. On an unknown date the patient was vaccinated with GARDASIL (route, dose, number of doses, lot# not reported). As was reported that on an unknown date the patient died from complications while using GARDASIL. No more information were provided. Additional information has been requested.


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