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This is VAERS ID 743431

Case Details

VAERS ID: 743431 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2018-04-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Unknown       Purchased by: ?
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: US0095075131804USA001041

Write-up: This spontaneous report was received from a non-healthcare professional via Pfizer refers to a 17 years old female patient. Patient''s medical history and concomitant medications were not reported. On an unknown date, the patient was vaccinated with GARDASIL (dosing information was not provided) for prophylaxis. On an unknown date, the patient died. It was unknown if the autopsy was performed. The cause of death was unknown. Reporter considered the event to be related to GARDASIL. Upon internal review, death was determined to be medically significant. This is one of the two reports received from the same reporter.; Reported Cause(s) of Death: unknown cause of death.


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