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This is VAERS ID 501081

Case Details

VAERS ID: 501081 (history)  
Form: Version 1.0  
Age:   
Gender: Female  
Location: Unknown  
Vaccinated:2013-08-22
Onset:2013-08-25
   Days after vaccination:3
Submitted: 2013-08-30
   Days after onset:5
Entered: 2013-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Death
SMQs:

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2013-08-25
   Days after onset: 0
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: WAES1308USA014250

Write-up: This spontaneous report as received from a health care worker refers to a female patient of unknown age. On 22-AUG-2013 the patient was vaccinated with a dose of GARDASIL (dose, route, lot number not provided). On 25-AUG-2013 the patient was found dead in her dorm room. The cause of dead had not been specified. Additional information has been requested.


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