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This is VAERS ID 384205

(NOTE: This result is from the 6/14/2014 version of the VAERS database)

Case Details

VAERS ID: 384205 (history)  
Form: Version .0  
Age: 13.0  
Sex: Female  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2010-04-02
Entered: 2010-04-05
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Death, Headache, Vaccine positive rechallenge
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: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES1003USA04772

Write-up: Information has been received from a nurse practitioner concerning a 13 year old female patient who on unspecified dates was vaccinated with three doses of GARDASIL at the nurse practitioner''s previous practice. The patient experienced headache after getting first and second dose of GARDASIL. The patient sought unspecified medical attention. After the third dose of GARDASIL the patient experienced headache and died on the same day. The cause of death was not reported. Additional information has been requested.


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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20140614&IDNUMBER=384205


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