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|Vaccination / Manufacturer||Lot / Dose||Site / Route|
|HPVX: HPV (NO BRAND NAME) / UNKNOWN MANUFACTURER||- / UNK||- / -|
Administered by: Unknown Purchased by: ??
Symptoms: Death, Skin depigmentation
Life Threatening? No
Birth Defect? No
Permanent Disability? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Diagnostic Lab Data:
CDC 'Split Type': CO0095075131909COL010677
Write-up: DEPIGMENTATION OF THE SKIN; This spontaneous report was received from the Agency (HA ref # 2019PVCL1500) and refers to a 9 (age units not reported) female patient. There was no information about the patient''s concurrent conditions, concomitant therapies, drug reactions, allergies or medical history provided. On an unknown date, the patient was vaccinated with quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (manufacturer unknown) dose reported as 200 milligram (strength, frequency, route of administration, anatomical location, lot # and expiration date were not reported) for prophylaxis. On an unknown date, the patient experienced depigmentation of the skin due to which she died on an unknown date. It was unknown if the autopsy was done. The Agency considered the event of depigmentation of the skin to be possibly related to quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (manufacturer unknown).; Reported Cause(s) of Death: DEPIGMENTATION OF THE SKIN
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