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This is VAERS ID 318244

Case Details

VAERS ID: 318244 (history)  
Form: Version 1.0  
Age: 20.0  
Gender: Female  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2008-07-03
Entered: 2008-07-07
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Unknown       Purchased by: Unknown
Symptoms: Death, Malaise, Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow)

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: Unknown
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0806USA09042

Write-up: Information has been received from a physician concerning a 20 year old female with no relevant medical history reported who was vaccinated with a first dose of GARDASIL on an unspecified date. Subsequently, exact onset not reported, the patient felt unwell. About 6 weeks post vaccination, she experienced pulmonary embolism with fatal outcome. An autopsy is scheduled. Other business partner numbers included: E2008-05832. Additional information has been requested.


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