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This is VAERS ID 691836

Case Details

VAERS ID: 691836 (history)  
Form: Version 1.0  
Age: 17.0  
Sex: Female  
Location: Colorado  
Vaccinated:2011-07-08
Onset:2011-07-28
   Days after vaccination:20
Submitted: 2017-04-25
   Days after onset:2098
Entered: 2017-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0181AA / 1 AR / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO) / NOVARTIS VACCINES AND DIAGNOSTICS U3514AA / 2 AR / IM

Administered by: Private       Purchased by: Other
Symptoms: Autopsy, Death
SMQs:

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2011-07-28
   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:
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: autopsy determined unknown cause of death
CDC Split Type:

Write-up: Layed down to take a nap and never woke up.


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