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This is VAERS ID 826060

Case Details

VAERS ID: 826060 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: California  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2019-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK - / -
HPV9: HPV (GARDASIL 9) / MERCK & CO. INC. - / UNK - / -

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: US0095075131907USA014251

Write-up: three days after vaccination the patient died; This spontaneous report was received from a nurse practitioner via a company representative and refers to a healthy female patient of unknown age. The patient''s concurrent conditions, medical history, concomitant therapies, drug reactions and allergies were not reported. On an unknown date, the patient was vaccinated with hpv rl1 6 11 16 18 31 33 45 52 58 vlp vaccine (yeast)(GARDASIL 9) or quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL), (unidentified Merck hpv vaccine administered; name, dose, route of administration, lot # and expiration date were not reported) for prophylaxis. On an unknown date, reported as three days after vaccination, the patient died. The cause of death was unknown. It was unknown if an autopsy was done. The relatedness between the patient''s death and suspect vaccine was not provided.


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