From the 11/26/2021 release of VAERS data:

This is VAERS ID 570801

Government Disclaimer on use of this data

Case Details

VAERS ID:	570801 (history)
Form:	Version 1.0
Age:	16.0
Sex:	Female
Location:	Virginia

Vaccinated:	2013-06-01
Onset:	2014-10-10
Days after vaccination:	496
Submitted:	2015-03-22
Days after onset:	163
Entered:	2015-03-22

Vaccination / Manufacturer	Lot / Dose	Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC.	- / UNK	AR / SYR

Administered by: Unknown Purchased by: Private
Symptoms: Death, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 2014-10-11
Days after onset: 1
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Syncope. Died at ER.

New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=570801