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This is VAERS ID 478227

Case Details

VAERS ID: 478227 (history)  
Form: Version 1.0  
Age:   
Gender: Female  
Location: Foreign  
Vaccinated:2012-11-25
Onset:2012-12-01
   Days after vaccination:6
Submitted: 2012-12-17
   Days after onset:16
Entered: 2012-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 2 UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Death, Oedema peripheral, Swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2012-12-17
   Days after onset: 16
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:
Allergies:
Diagnostic Lab Data:
CDC Split Type: WAES1212NPL005349

Write-up: This spontaneous report as received from a physician via a business partner refers to a female patient of unknown age. The patient was vaccinated with the second dose of GARDASIL (lot number, dose, route, and strength were not reported). on 25-NOV-2012. No other co-suspects were reported. No concomitant medications were reported. Following the vaccination on that evening, on 25-NOV-2012, the patient had little bit of swollen hand. She did not come to her class the next day, but a day after that, she had been moving around and attending her classes. But on 29-NOV-2012, her body was swollen and she died on 01-DEC-2012. The outcome of swollen hand and swollen body was unknown. The patient''s death was confirmed, her parents did not file any complain and the physician was told that it was not in relation with the vaccine administration. Based on the written field report the physician got from the local program coordinator, the death was not caused by vaccination. Additional information is not expected.


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