|
VAERS ID: |
442402 (history) |
Form: |
Version 1.0 |
Age: |
15.0 |
Sex: |
Male |
Location: |
Oregon |
Vaccinated: | 2011-10-17 |
Onset: | 2011-10-17 |
Days after vaccination: | 0 |
Submitted: |
2011-11-14 |
Days after onset: | 28 |
Entered: |
2011-11-14 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. |
1262AA / UNK |
RA / IM |
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR |
U4006AA / UNK |
RA / IM |
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS |
AC52B072EA / UNK |
RA / IM |
Administered by: Private Purchased by: Public Symptoms: Death,
Pain,
Swelling SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 2011-10-20
Days after onset: 3
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Other Medications: Depakote, Lyrica, Diazapam, Adderall Current Illness: No Preexisting Conditions: Seizure Disorder Allergies: Diagnostic Lab Data: CDC Split Type:
Write-up: Initial soreness and swelling. Death 10/20/2011. |
|
VAERS ID: |
449334 (history) |
Form: |
Version 1.0 |
Age: |
19.0 |
Sex: |
Female |
Location: |
Unknown |
Vaccinated: | 2009-01-01 |
Onset: | 2011-08-27 |
Days after vaccination: | 968 |
Submitted: |
2012-02-09 |
Days after onset: | 166 |
Entered: |
2012-02-10 |
Days after submission: | 1 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. |
- / UNK |
UN / UN |
Administered by: Other Purchased by: Other Symptoms: Amyotrophic lateral sclerosis,
Death,
Gene mutation identification test positive SMQs:
Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 2011-08-27
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: Unknown Current Illness: Gene mutation Preexisting Conditions: Allergies: Diagnostic Lab Data: diagnostic laboratory, genetic mutation (FUS): positive CDC Split Type: WAES1202USA00710
Write-up: Information has been received from a physician concerning a 19 year old female who on an unspecified date was vaccinated with a dose of GARDASIL (lot # not reported, dose number unknown). Approximately a year and a half prior to developing the onset of rapidly progressive ALS (amyotrophic lateral sclerosis). It was unknown if the patient was on any medications or had concomitant vaccinations. Patient died within a year of symptom onset. Patient was found to be positive for a genetic mutation (FUS) recently recognized as associated with early-onset, rapidly progressive ALS. Her parents also had the mutation. It was not reported if the patient had sought medical attention. This is one of several reports received from the same source. Additional information has been requested. |
|
VAERS ID: |
450655 (history) |
Form: |
Version 1.0 |
Age: |
12.0 |
Sex: |
Female |
Location: |
Michigan |
Vaccinated: | 2012-02-23 |
Onset: | 0000-00-00 |
Submitted: |
2012-02-27 |
Entered: |
2012-02-28 |
Days after submission: | 1 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEPA: HEP A (VAQTA) / MERCK & CO. INC. |
1441AA / 2 |
LA / IM |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. |
1495AA / 3 |
LA / IM |
Administered by: Private Purchased by: Private Symptoms: Death SMQs:
Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 2012-02-26
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Other Medications: None Current Illness: None Preexisting Conditions: None Allergies: Diagnostic Lab Data: CDC Split Type:
Write-up: None at time of service. Pt. expired 2-26-12. |
|
VAERS ID: |
451701 (history) |
Form: |
Version 1.0 |
Age: |
30.0 |
Sex: |
Female |
Location: |
Maryland |
Vaccinated: | 2011-03-25 |
Onset: | 2011-06-05 |
Days after vaccination: | 72 |
Submitted: |
2012-03-12 |
Days after onset: | 281 |
Entered: |
2012-03-14 |
Days after submission: | 2 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS |
AHPVA102AB / 2 |
LA / UN |
Administered by: Other Purchased by: Other Symptoms: Abdominal pain,
Exploratory operation,
Hepatic mass,
Hepatic neoplasm malignant non-resectable,
Jaundice,
Laboratory test,
Laparotomy,
Nausea,
Palliative care,
Pruritus generalised,
Terminal state,
Ultrasound abdomen abnormal,
Vomiting SMQs:, Liver related investigations, signs and symptoms (narrow), Cholestasis and jaundice of hepatic origin (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Biliary system related investigations, signs and symptoms (narrow), Biliary tract disorders (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Liver malignant tumours (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Non-haematological malignant tumours (narrow)
Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 2011-12-24
Days after onset: 202
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 19 days
Extended hospital stay? No
Previous Vaccinations: Other Medications: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type:
Write-up: On 8/30/2011 subject reported by phone that she had started on 6/5/2011 with diffuse abdominal pain of moderate-to-severe intensity, nausea, vomits, generalized pruritus, and jaundice. Abdominal sonogram on 7/22/2011 showed a mass in the liver. Local hospital admission (7/23/2011) and testing led to referral to national hospital and exploratory laparotomy (8/8/2011), and discovery of liver tumor (5 cm diameter) in the portal vein bifurcation with infiltration of the extrahepatic bile duct. Tumor was unremovable. She was discharged 8/11/2011 with treatment against pruritus and referral to Oncology (appt 9/7/2011). On 12/22/2011 subject was in terminal phase, receiving palliative care at home; diagnosis was liver cancer. |
|
VAERS ID: |
451703 (history) |
Form: |
Version 1.0 |
Age: |
28.0 |
Sex: |
Female |
Location: |
Maryland |
Vaccinated: | 2005-02-16 |
Onset: | 2010-06-03 |
Days after vaccination: | 1933 |
Submitted: |
2012-03-12 |
Days after onset: | 648 |
Entered: |
2012-03-14 |
Days after submission: | 2 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS |
VX10787 / 3 |
LA / UN |
Administered by: Other Purchased by: Other Symptoms: Chemotherapy,
Colitis,
Hysterectomy,
Mass excision,
Metastasis,
Ovarian cancer stage III,
Ovarian disorder,
Pelvic discomfort,
Pelvic pain,
Stomach mass,
Ultrasound ovary abnormal SMQs:, Pseudomembranous colitis (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Gastrointestinal nonspecific inflammation (narrow), Ischaemic colitis (broad), Ovarian malignant tumours (narrow), Uterine and fallopian tube tumours of unspecified malignancy (broad), Noninfectious diarrhoea (broad), Non-haematological malignant tumours (narrow), Immune-mediated/autoimmune disorders (broad)
Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 2011-10-23
Days after onset: 507
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:
Write-up: Between June-August 2010, subject started with pain/discomfort in pelvic region. She consulted her local primary care center and was diagnosed and treated for colitis. After symptomology progressively worsened she was given a sonogram (8/25/2010) that showed "shadows on ovaries". Following readmission (8/30/2010), surgeons on 9/1/2010 removed a mass apparently started in the stomach; they told subject''s sister it was invasive cancer. Hospital admission and multiple chemotherapy courses took place in 9/2010 and 10/2010, then total hysterectomy (1/28/2011) and more chemo (5/2011). On 6/22/2011 she was admitted with diagnosis of ovarian cancer stage III C. Was taking Hyoscine, methadone, and bisacodyl as necessary. |
|
VAERS ID: |
453010 (history) |
Form: |
Version 1.0 |
Age: |
16.0 |
Sex: |
Female |
Location: |
Kentucky |
Vaccinated: | 2012-03-20 |
Onset: | 2012-03-29 |
Days after vaccination: | 9 |
Submitted: |
2012-04-04 |
Days after onset: | 6 |
Entered: |
2012-04-04 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. |
0692AA / 2 |
RA / IM |
Administered by: Private Purchased by: Public Symptoms: Death SMQs:
Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 2012-03-29
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: Loestrin 1/20mg one daily. Cetraxal 0.2% solution 2 drops bid for 7 days Current Illness: none Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type:
Write-up: Undetermined cause death occurred nine days after 2nd injection of Gardasil. 1st dose on 01/31/2012. |
|
VAERS ID: |
457904 (history) |
Form: |
Version 1.0 |
Age: |
14.0 |
Sex: |
Male |
Location: |
Wisconsin |
Vaccinated: | 2012-06-04 |
Onset: | 2012-06-07 |
Days after vaccination: | 3 |
Submitted: |
2012-06-21 |
Days after onset: | 14 |
Entered: |
2012-06-22 |
Days after submission: | 1 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. |
1224AA / 2 |
LA / IM |
Administered by: Other Purchased by: Other Symptoms: Completed suicide,
Death,
Gun shot wound SMQs:, Suicide/self-injury (narrow), Accidents and injuries (narrow), Hostility/aggression (broad)
Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 2012-06-07
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: None Current Illness: Preexisting Conditions: None Allergies: Diagnostic Lab Data: Unknown CDC Split Type: WAES1206USA02932
Write-up: Information has been received from a physician concerning a 14 year old male with no pertinent medical history and no drug allergies who was vaccinated intramuscularly with the first and second 0.5ml dose of GARDASIL (Lot# not reported) respectively on 02-APR-2012 and 04-JUN-2012. There was no concomitant medication. On 07-JUN-2012 the patient committed suicide. He shot himself in head. Physician stated this young male was happy go lucky, healthy, and never had any psychiatric issues in the past. It was not known if the patient sought for medical attention. On 07-JUN-2012 the patient died of suicide. Additional information has been requested. |
|
VAERS ID: |
464953 (history) |
Form: |
Version 1.0 |
Age: |
19.0 |
Sex: |
Female |
Location: |
Unknown |
Vaccinated: | 0000-00-00 |
Onset: | 0000-00-00 |
Submitted: |
2012-09-13 |
Entered: |
2012-09-13 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. |
- / 1 |
UN / SYR |
Administered by: Military Purchased by: Other Symptoms: Central nervous system infection,
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: No other medications Current Illness: Unknown Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type: WAES1209USA003315
Write-up: Information has been received from a receptionist of the registered nurse, concerning rumor going around that a 19 years old girl who on an unspecified date received the first shot of GARDASIL (dose, route and lot # not reported), developed a brain infection, and passed away. The patient died this summer, June/July 2012. The reporter was not even 100% sure if the patient had had the GARDASIL shot because the nurses found that there was no record of the patient in local registry for GARDASIL patients. They were assuming that she was vaccinated out of state because she had joined the military (unspecified). The patient might have gotten vaccinated by the military. Another part of the rumor that was going around was that "the girl was fine one day, not the next, and it must be the GARDASIL shot that did this". The time from receiving the GARDASIL shot to the time of her death was unknown. It was unknown if she had any adverse experience from the GARDASIL or if it caused the brain infection. Additional information has been requested. |
|
VAERS ID: |
471590 (history) |
Form: |
Version 1.0 |
Age: |
|
Sex: |
Unknown |
Location: |
Unknown |
Vaccinated: | 0000-00-00 |
Onset: | 0000-00-00 |
Submitted: |
2012-10-26 |
Entered: |
2012-10-26 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. |
- / UNK |
UN / UN |
Administered by: Other Purchased by: Other 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: No other medications Current Illness: Unknown Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type: WAES1210USA012210
Write-up: This spontaneous report as received from a consumer, who learned from a foreign radio channel of fatal cases after GARDASIL vaccination in one country (1210USA012211) and a second country (2 fatal cases, 1210HKG011628) and in a third country (3 fatal cases, this case). The reporter himself experienced serious adverse events (1210HKG011385). This report refers to three patients of unknown age. The patients were vaccinated with GARDASIL (date and route of administration not provided). No other co-suspects were reported. No concomitant medications were reported. On an unknown date the patients died. No details for death are available. The relatedness for death is unknown for GARDASIL. Additional information has been requested. |
|
VAERS ID: |
482344 (history) |
Form: |
Version 1.0 |
Age: |
|
Sex: |
Female |
Location: |
Unknown |
Vaccinated: | 0000-00-00 |
Onset: | 0000-00-00 |
Submitted: |
2013-01-23 |
Entered: |
2013-01-23 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. |
- / UNK |
UN / UN |
Administered by: Other Purchased by: Other 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: No other medications Current Illness: Unknown Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type: WAES1301USA010664
Write-up: This spontaneous report as received via social media refers to a female patient of unknown age, who on an unspecified date was vaccinated with a dose of GARDASIL (dose and lot number were not reported). No other co-suspects were reported. No concomitant medications were reported. The other reported that the patient died after vaccination. The relatedness for the adverse event was unknown for GARDASIL. This is one of the several reports from the same source. Additional information is not expected. |
|