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From the 4/23/2021 release of VAERS data:

This is VAERS ID 764583



Case Details

VAERS ID: 764583 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2018-08-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK - / IM

Administered by: Unknown       Purchased by: ?
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: JP0095075131808JPN000572J

Write-up: This spontaneous report was received from an other health professional. Information has been received from an other health professional concerning 20-40 years old female patient. The patient was vaccinated with GARDASIL (AQUEOUS SUSPENSION FOR INTRAMUSCULAR INJECTION SYRINGE), intramuscular (start date and dose not reported). No concomitant medications were reported. Adverse experience (term as stated by respondent): Died. Concomitant therapy (include dose, indication, etc.), concurrent conditions, medical history, diagnostic tests carried out to diagnose AE: N/A. On an unknown date, the patient was dead. The cause of death and an autopsy were not reported. Reporter''s comment: The AE case was acknowledged via News within the recent two years, in which the news reported that two women died in a few months after receiving HPV vaccine. Reporter did not capture any screenshots from the news website. Reporter was unable to provide any details on the brand of the vaccine. Upon internal review, death was considered to be serious (other medically significant). Reported Cause(s) of Death: Death.


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