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This is VAERS ID 489163

Case Details

VAERS ID: 489163 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Unknown  
Location: Virginia  
Submitted: 2013-04-15
   Days after onset:79
Entered: 2013-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Death, Foetal exposure during pregnancy, Toxicologic test
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2013-01-25
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1304USA006581

Write-up: Information has been received from a mother for GARDASIL, a Pregnancy Registry product, concerning her 8 week old baby. On an unknown date in December 2011 the mother was vaccinated with the first dose of GARDASIL (lot number 0626AA) (dose, route and injection site were not reported). On 28-FEB-2012, the mother was vaccinated with the second dose of GARDASIL (lot number, dose, route and injection site were not reported). On 23-MAR-2012 the mother found she was pregnant and on 26-NOV-2012 she delivered the infant. The baby was born on 26-NOV-2012, and died on 25-JAN-2013. Toxicology tests are being run to see the cause of death. The action taken and causality of death was not provided. The mother''s information was captured in MARRS # 1304USA006478 (Parent-Child Link). Additional information is not expected.

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