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From the 10/14/2018 release of VAERS data (an older release, current is 1/14/2022):

This is VAERS ID 544217

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Case Details

VAERS ID: 544217 (history)  
Form: Version 1.0  
Age: 12.0  
Sex: Female  
Location: New Jersey  
Submitted: 2014-09-18
Entered: 2014-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Death, Malaise

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:
Diagnostic Lab Data:
CDC Split Type: WAES1409USA006093

Write-up: This spontaneous report as received from a physician (who heard from an unspecified media source) via a company representative refers to a 14 year old female patient. On an unknown date the patient was vaccinated with her first dose of GARDASIL (dose, route, lot number and expiration date not provided). Physician stated that the patient went home, felt a little sick, laid down and died on an unknown date. The outcome of felt a little sick was unknown. Relatedness between the events: felt a little sick and the patient died was not reported. Follow up information was received from a physician via company representative. Physician reported that media source stated that the patient was 12 years old (not 14 years as previously reported). Company representative stated that she found the article on a website and it may have been reported via other media channels. An official cause of death was not mentioned. Additional information has been requested.

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