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This is VAERS ID 393871

(NOTE: This result is from the 7/31/2010 version of the VAERS database)

Case Details

VAERS ID: 393871 (history)  
Form: Version .0  
Age: 15.0  
Sex: Female  
Location: Foreign  
   Days after vaccination:3
Submitted: 2010-07-28
   Days after onset:61
Entered: 2010-07-29
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Unknown       Purchased by: Unknown
Symptoms: Completed suicide, Death
SMQs:, Suicide/self-injury (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2010-05-28
   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:
Preexisting Conditions: Depression
Diagnostic Lab Data: Unknown
CDC Split Type: WAES1007USA03148

Write-up: Information has been received from the agency via a Case Line Listing via CSL, as part of a business agreement, concerning a 15 year old female patient with a history of depression who on 25-MAY-2010, was vaccinated with the second 0.5 ml IM dose of GARDASIL (batch # NK20450, lot # NJ29430). On 28-MAY-2010, within one week following vaccination, the patient experienced suicide (severe) and died. The cause of death was suicide. The agency felt that suicide was unlikely related to therapy with GARDASIL. No further information is available. A lot check has been initiated. This was originally reported by a practice nurse.

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