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This is VAERS ID 334611

(NOTE: This result is from the 12/31/2008 version of the VAERS database)

Case Details

VAERS ID: 334611 (history)  
Form: Version .0  
Age: 19.0  
Sex: Female  
Location: Illinois  
Vaccinated:2008-11-26
Onset:2008-12-08
   Days after vaccination:12
Submitted: 2008-12-10
   Days after onset:2
Entered: 2008-12-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUN: INFLUENZA (FLUMIST) / MEDIMMUNE VACCINES, INC. 500569P / - - / -
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0070X / 2 LA / -
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U2730AA / - RA / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Autopsy, Death, Headache, Malaise
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2008-12-08
   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 known. ?? oral contraceptive or an antibiotic for acne.
Current Illness: None.
Preexisting Conditions: Acne.
Allergies:
Diagnostic Lab Data: Autopsy performed 12-9-08 was unrevealing per family verbal report to me; no signs of intracranial bleed, meningitis, cardiomyopathy, trauma. Toxicology report still pending at this time.
CDC Split Type:

Write-up: Patient, a previously healthy 19 year-old female college freshman died suddenly yesterday, approximately 10 days after receiving Gardasil & menningococcal vaccines. Vaccines were administered by a medical provider in her hometown while she was home for th"e Thanksgiving holiday, sometime around 11-28-08. She had a medical appointment pending for 12-8-08 (the day of her death) with the Student Health Service; medical clerk had entered /"possible seizure/" as the reason for making the appointment. Patient ha


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20081231&IDNUMBER=334611


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