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This is VAERS ID 719492

Case Details

VAERS ID: 719492 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2017-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Death, Leukaemia
SMQs:, Haematological malignant tumours (narrow)

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: US0095075131710USA005030

Write-up: This spontaneous report was received from a physician via an online article, referring to a female patient of unknown age. The patient''s medical history, concurrent conditions, concomitant medications, and historical drugs were not reported. On an unknown date, the patient was vaccinated by her mother who was a nurse, with GARDASIL (route, dose, frequency, anatomical location, lot # and expiration date were unknown) for prophylaxis. The article reported that the girl on an unspecified date developed leukemia and died. I was unknown if an autopsy was done to the patient. The reported did not mention the causality assessment between the events of leukemia and death with GARDASIL. Upon internal review, leukemia and death were determined to be medically significant.; Sender''s Comments: US-009507513-1710USA004070:


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