|
VAERS ID: |
482352 (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: WAES1301USA010666
Write-up: This spontaneous report as received via social media who reported multiple patients (unknown age and gender) who on an unspecified date were 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 reporter stated that on an unspecified date, the patients died from the vaccine. No treatment information was reported. At the time of the report, the patients outcome for the adverse event was fatal. The relatedness for the adverse event was related for GARDASIL. This is one of the several reports from the same source. Additional information is not expected. |
|
VAERS ID: |
485188 (history) |
Form: |
Version 1.0 |
Age: |
|
Sex: |
Unknown |
Location: |
Unknown |
Vaccinated: | 0000-00-00 |
Onset: | 0000-00-00 |
Submitted: |
2013-02-21 |
Entered: |
2013-02-21 |
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: WAES1302USA006176
Write-up: This spontaneous report as received from internet referred to three patients of unknown age. On an unknown date the patients were vaccinated with GARDASIL (Lot#, dose/frequency, route and duration were unspecified). Then on an unknown date the patients died (three deaths have been reported along with more reports of paralysis in girls who had gotten the poorly tested HPV vaccine). The date and cause of death were not reported. It was unknown whether autopsy was done. This is one of several reports that received from the same source. Additional information has been requested. |
|
VAERS ID: |
485757 (history) |
Form: |
Version 1.0 |
Age: |
11.0 |
Sex: |
Female |
Location: |
New York |
Vaccinated: | 2013-02-19 |
Onset: | 2013-02-19 |
Days after vaccination: | 0 |
Submitted: |
2013-02-25 |
Days after onset: | 6 |
Entered: |
2013-02-28 |
Days after submission: | 3 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS |
AHAVB677CA / UNK |
UN / UN |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. |
H016238 / UNK |
UN / UN |
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR |
U42927 / UNK |
UN / UN |
TDAP: TDAP (ADACEL) / SANOFI PASTEUR |
U4431BA / UNK |
UN / UN |
Administered by: Private Purchased by: Unknown Symptoms: Cardiac arrest,
Crying,
Death,
Endotracheal intubation,
Respiratory arrest,
Skin discolouration SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Angioedema (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Depression (excl suicide and self injury) (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Respiratory failure (narrow)
Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 2013-02-20
Days after onset: 1
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Other Medications: DILANTIN; Phenobarb Current Illness: Medical record - cough - resp sym x 5 days (doc denies) Preexisting Conditions: Microcephaly; seizure Allergies: Diagnostic Lab Data: See reverse CDC Split Type:
Write-up: 2/19/13 23:24 Pt brought in by ambulance in cardiac arrest, "mother states pt has been having cough & URI symptoms since 5 days - seen by doctor 2/19/13 & given 4 vaccines. Pt sleeping & crying - suddenly pt turned white & was not breathing - 911 called & intubated. Doctor states he was not aware of any illness & child''s DILANTIN level was 1.0. No lab found in medical record child revived & transfer to another hospital where child died on 2/20/13. |
|
VAERS ID: |
489163 (history) |
Form: |
Version 1.0 |
Age: |
0.2 |
Sex: |
Unknown |
Location: |
Virginia |
Vaccinated: | 0000-00-00 |
Onset: | 2013-01-25 |
Submitted: |
2013-04-15 |
Days after onset: | 79 |
Entered: |
2013-04-15 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. |
- / 2 |
UN / UN |
Administered by: Other Purchased by: Other Symptoms: Death,
Foetal exposure during pregnancy,
Toxicologic test SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)
Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 2013-01-25
Days after onset: 0
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? Yes
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: WAES1304USA006581
Write-up: Information has been received from a mother for GARDASIL, a Pregnancy Registry product, concerning her 8 week old baby. On an unknown date in December 2011 the mother was vaccinated with the first dose of GARDASIL (lot number 0626AA) (dose, route and injection site were not reported). On 28-FEB-2012, the mother was vaccinated with the second dose of GARDASIL (lot number, dose, route and injection site were not reported). On 23-MAR-2012 the mother found she was pregnant and on 26-NOV-2012 she delivered the infant. The baby was born on 26-NOV-2012, and died on 25-JAN-2013. Toxicology tests are being run to see the cause of death. The action taken and causality of death was not provided. The mother''s information was captured in MARRS # 1304USA006478 (Parent-Child Link). Additional information is not expected. |
|
VAERS ID: |
492468 (history) |
Form: |
Version 1.0 |
Age: |
|
Sex: |
Female |
Location: |
Unknown |
Vaccinated: | 0000-00-00 |
Onset: | 0000-00-00 |
Submitted: |
2013-05-24 |
Entered: |
2013-05-24 |
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: WAES1305USA013443
Write-up: This spontaneous report as received from a female consumer via company representative who refers to her niece. On an unknown date the patient was vaccinated with GARDASIL (route, dose, number of doses, lot# not reported). As was reported that on an unknown date the patient died from complications while using GARDASIL. No more information were provided. Additional information has been requested. |
|
VAERS ID: |
494024 (history) |
Form: |
Version 1.0 |
Age: |
18.0 |
Sex: |
Male |
Location: |
Texas |
Vaccinated: | 2012-01-25 |
Onset: | 2012-01-25 |
Days after vaccination: | 0 |
Submitted: |
2013-06-12 |
Days after onset: | 503 |
Entered: |
2013-06-12 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. |
1397AA / 1 |
LA / IM |
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR |
U4032AA / 2 |
LA / IM |
Administered by: Public Purchased by: Public Symptoms: Cerebral haemorrhage,
Coma,
Death,
Haematemesis,
Injection site bruising,
Leukaemia,
Oropharyngeal pain,
Pyrexia,
Unresponsive to stimuli SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemorrhagic central nervous system vascular conditions (narrow), Gastrointestinal haemorrhage (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Haematological malignant tumours (narrow)
Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 2012-02-10
Days after onset: 16
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
Extended hospital stay? No
Previous Vaccinations: Other Medications: None known Current Illness: None known Preexisting Conditions: None known Allergies: Diagnostic Lab Data: CDC Split Type:
Write-up: On 1/25/2012, as per mother patient developed a black bruise to the left upper arm where vaccines had been administered that covered most of the entire upper arm. On February 1, 2012, he developed a sore throat and fever that lasted a week. On February 7, 2012 at 11 am he reported to hospital. As per mother, patient was non-responsive and was throwing up blood-tinged saliva. He was flown out due to an internal hemorrhage. He was admitted to hospital at around 3 pm. After admission, he remained unresponsive. As per mother, the internal cerebral hemorrhage was too advanced and the patient was not a candidate for surgery so patient eventually became comatose. He passed away on 2/10/2012 at 2 am. Final diagnosis was cerebral hemorrhage and leukemia. As per parent, the client had no previous history of illnesses at the time of vaccination on 1/25/2012. |
|
VAERS ID: |
495540 (history) |
Form: |
Version 1.0 |
Age: |
31.0 |
Sex: |
Female |
Location: |
Maryland |
Vaccinated: | 2006-05-02 |
Onset: | 2012-09-25 |
Days after vaccination: | 2338 |
Submitted: |
2013-06-28 |
Days after onset: | 276 |
Entered: |
2013-06-28 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS |
VX17027 / 1 |
LA / UN |
Administered by: Other Purchased by: Other Symptoms: Death SMQs:
Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 2012-09-25
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: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type:
Write-up: Subject was enrolled in Vaccine Trial and received 3 doses of CERVARIX. Following closeout from CVT in 12/17/2010, patient continued in Extended Follow-up Study (since 8/1/2011). At study visit on 6/21/2013, parents-in-law of patient reported she passed away at home on 9/25/2012. Patient has hx of severe dilated cardiomyopathy starting in 2008, and suffered severe respiratory illnesses and a stroke in 2010 and 2011, respectively. Cause of death was believed to be related to her underlying heart condition and not related to vaccination. |
|
VAERS ID: |
500225 (history) |
Form: |
Version 1.0 |
Age: |
|
Sex: |
Unknown |
Location: |
Unknown |
Vaccinated: | 0000-00-00 |
Onset: | 0000-00-00 |
Submitted: |
2013-08-23 |
Entered: |
2013-08-23 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. |
- / UNK |
UN / UN |
Administered by: Other Purchased by: Other Symptoms: Convulsion,
Loss of consciousness,
Seizure like phenomena SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)
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: WAES1308USA010574
Write-up: This spontaneous report as received from a consumer''s mother refers to a patient of unknown age. The reporter''s daughter experienced seizure-like reaction, the patient convulsed for "2-3 seconds" and then "passed out" for a "few seconds" after receiving first dose of GARDASIL. (Captured in case 1308USA009926). The patient''s mother called the office after her child''s reaction and stated that she has done some research (source unknown) and found out that seizure-like reaction was common after GARDASIL administration and she also found from her research that someone has died from GARDASIL reaction and was concerned. In this unconfirmed AE report was reported on an unknown date this patient was vaccinated with GARDASIL (dosing information and route are unknown). On an unknown date this patient experienced GARDASIL reaction. The outcome of GARDASIL reaction was reported as fatal. No reporter causality provided. No consent to contact physician. Additional information is not expected. |
|
VAERS ID: |
501081 (history) |
Form: |
Version 1.0 |
Age: |
|
Sex: |
Female |
Location: |
Unknown |
Vaccinated: | 2013-08-22 |
Onset: | 2013-08-25 |
Days after vaccination: | 3 |
Submitted: |
2013-08-30 |
Days after onset: | 5 |
Entered: |
2013-08-30 |
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? Yes
Birth Defect? No
Died? Yes
Date died: 2013-08-25
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: No other medications Current Illness: Unknown Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type: WAES1308USA014250
Write-up: This spontaneous report as received from a health care worker refers to a female patient of unknown age. On 22-AUG-2013 the patient was vaccinated with a dose of GARDASIL (dose, route, lot number not provided). On 25-AUG-2013 the patient was found dead in her dorm room. The cause of dead had not been specified. Additional information has been requested. |
|
VAERS ID: |
501663 (history) |
Form: |
Version 1.0 |
Age: |
17.0 |
Sex: |
Female |
Location: |
Michigan |
Vaccinated: | 2013-08-09 |
Onset: | 2013-08-22 |
Days after vaccination: | 13 |
Submitted: |
2013-08-30 |
Days after onset: | 8 |
Entered: |
2013-09-06 |
Days after submission: | 7 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. |
H020848 / 1 |
UN / IM |
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR |
U4584BA / 2 |
UN / IM |
Administered by: Unknown Purchased by: Unknown Symptoms: Death SMQs:
Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 2013-08-22
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: Current Illness: Preexisting Conditions: No known allergies. Allergies: Diagnostic Lab Data: Not reported CDC Split Type: 201309264
Write-up: Initial report was received 26 August 2013 from a health care professional. A 17-year-old female patient with no known allergies had received a second dose intramuscular injection of MENACTRA, lot number U4584BA and a first dose intramuscular injection of GARDASIL (manufacturer Merck, lot number H020848) (sites of administration not reported) on 09 August 2013, and 13 days later on 22 August 2013, the patient died. There was no contact with the physician after MENACTRA had been given. The patient had previously received a first dose injection of MENACTRA on 04 September 2008. The reporter had been contacted by the county medical examiner who informed the reporter about the death and requested the patient''s medical history. The reporter contacted the CDC (Centers for Disease Control and Prevention) who told them to call and report the event to VAERS. No additional information was provided at the time of the report. Documents held by sender: None. |
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