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This is VAERS ID 374780

Case Details

VAERS ID: 374780 (history)  
Form: Version 1.0  
Age: 14.0  
Gender: Unknown  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2009-12-21
Entered: 2009-12-22
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Unknown       Purchased by: Unknown
Symptoms: Autoimmune disorder, 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0912USA02326

Write-up: Information was reported in a newspaper article that a 14 year old female patient who on an unspecified date was vaccinated with a dose of GARDASIL vaccine (lot number, date, route and site not reported). Subsequently the patient experienced auto-immune symptoms and died 21 months later. The article also discussed the multiple sclerosis of other 5 patient while on therapy with GARDASIL vaccine (WAES 0912USA01664, WAES 0912USA02322, WAES 0912USA02323, WAES 0912USA02324, and WAES 0912USA02325, WAES 0912USA02639, WAES 0912USA02640, WAES 0912USA02641, WAES 0912USA02642 and WAES 0912USA02643. No further information is available.


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