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This is VAERS ID 738637

Case Details

VAERS ID: 738637 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Unknown  
Submitted: 0000-00-00
Entered: 2018-02-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Coma, Contusion, Death, Dyspnoea, Fatigue, General physical health deterioration, Haemoglobin decreased, Injection site haemorrhage, Lethargy, Leukaemia, Life support, Lymphadenopathy, Meningitis, Menorrhagia, Oropharyngeal pain, Pain, Pain in extremity, Pallor, Petechiae, Pyrexia, Sepsis, Swelling, Transfusion, White blood cell count decreased
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Haematopoietic erythropenia (broad), Haematopoietic leukopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Accidents and injuries (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Respiratory failure (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Hypoglycaemia (broad), Haematological malignant tumours (narrow), Sepsis (narrow), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2008-01-03
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 304 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: US0095075131802USA010929

Write-up: This spontaneous report was received from a medical assistant (patient''s mother) refers to 16 years old female patient. Pertinent medical history and concomitant medication were not reported. On an unknown date in October 2006, the patient was vaccinated with first dose of GARDASIL for prophylaxis, lot# 0668F, expiry date 21-NOV-2008 (strength, dose were unknown) in the office. After the first dose of GARDASIL the patient always felt tired. The patient also complained all the time that her legs ached. It was hard for her to get across campus because she felt very winded all the time. On an unknown date in November 2006, the patient was vaccinated with second dose of GARDASIL in her arm. After second vaccination, her arm would not stop bleeding and the reporter had to hold it until it stopped bleeding. The patient became very puffy, lethargic and on and off she''d have a sore throat. The patient had not received the third dose of GARDASIL. It was reported that, the patient experienced 104-105 fever at home and she kept going through ibuprofen. Her body was aching and she didn''t know, her period too that would just be prolonged, she had a sore throat and some swollen lymph nodes. The physician thought it was tonsillitis, hence she was prescribed of amoxicillin. After two-week round of antibiotics, the patient came back because she hadn''t gotten any better. She looked white as a ghost, very weak. The reporter had to almost carry her into the doctor''s office. The patient was very pale, she looks anemic. The hemoglobin was 4. She had bruising on her legs and petechiae. The patient was hospitalized. On an unknown date in March 2007, the patient was diagnosed with leukemia. The patient received blood transfusion. The reporter stayed in the hospital for 10 months pretty much straight. They weren''t allowed to leave because of her white blood cell count and her contacting other viruses. So, they were allowed to leave if her blood count was high enough. On an unknown date in October 2007, the patient experienced first coma and was supported with life support. On 03-JAN-2008, in the morning, the reporter was informed that, her daughter was having trouble breathing and experienced second coma. The patient''s condition got deteriorated and they couldn''t tell if there was any brain function. As of 03-JAN-2008, the patient had meningitis and sepsis. The patient died on 03-JAN-2008 due to deterioration of leukemia. It was unknown if the autopsy was performed. The outcome of leukemia was reported as fatal. The causality was not reported. The reporter considered the event leukemia as serious due to hospitalization and medically significant. Reported Cause(s) of Death: Leukemia deteriorated.

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