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This is VAERS ID 515434

Case Details

VAERS ID: 515434 (history)  
Form: Version 1.0  
Age: 16.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2013-05-23
Onset:2013-07-04
   Days after vaccination:42
Submitted: 2013-12-03
   Days after onset:152
Entered: 2013-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. H016238 / 1 LA / IM

Administered by: Private       Purchased by: Unknown
Symptoms: Sudden death
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2013-07-04
   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: ALBUTEROL
Current Illness: No illnesses at time of vaccination
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Sudden death. He was perfectly healthy. This vaccination is the only thing I can think of that would have caused this. Everything else in his life was normal, the same.


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