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This is VAERS ID 836098

History of Changes from the VAERS Wayback Machine

First Appeared on 2/14/2020

VAERS ID: 836098
VAERS Form:2
Age:
Sex:Female
Location:Foreign
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:2019-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPVX: HPV (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Condition aggravated, Death, Systemic lupus erythematosus

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Lupus erythematosus
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CO0095075131909COL011382

Write-up: Erythematosus lupus empeoring; This spontaneous report was received from a regulatory authority and refers to a 16 (units not provided) female patient. There was no information about the patient''s concomitant therapies or medical history provided. Her concurrent conditions included lupus erythematosus. On an unknown date, the patient was vaccinated with quadrivalent human papillomavirus (types 6,11,16,18) recomb. Vaccine (manufacturer unknown) (second dose, frequency, route of administration, anatomical location, lot # and expiration date were not provided) for prophylaxis. On an unknown date, the patient experienced worsening of lupus erythematosus and died due to it on an unknown date. It was unknown if autopsy was performed. The relatedness between the event and quadrivalent human papillomavirus (types 6,11,16,18) recomb. Vaccine (manufacturer unknown) was reported as possible.; Reported Cause(s) of Death: Systemic lupus erythematosus

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