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This is VAERS ID 387160

Case Details

VAERS ID: 387160 (history)  
Form: Version 1.0  
Age: 16.0  
Gender: Female  
Location: Hawaii  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2010-05-10
Entered: 2010-05-11
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Autopsy, Death, Headache
SMQs:

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2009-10-24
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: WAES1005USA00536

Write-up: Information has been received from a physician who found out from another treating physician who was also the father of the patient, concerning a 16 year old female patient who on an unknown date, was vaccinated with a dose of GARDASIL. Subsequently the patient developed a severe headache. Then the patient went to sleep that night and passed away. The autopsy was performed which revealed no cause of death. It is unknown if the patient sought medical attention. Severe headache was considered to be immediately life-threatening. Additional information has been requested.


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