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This is VAERS ID 528766

Case Details

VAERS ID: 528766 (history)  
Form: Version 1.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2014-04-18
Entered: 2014-04-18
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: WAES1404USA008954

Write-up: This spontaneous report was received from a registered nurse who read about the life story of a patient of unknown age on a website. On an unknown date the patient was vaccinated with GARDASIL, (dose, lot no. route not reported). On an unknown date the patient died from an unspecified cause. This is one of reports received from the same source. Additional information is not expected.


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