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This is VAERS ID 836102

Case Details

VAERS ID: 836102 (history)  
Form: Version 2.0  
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 - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Death
SMQs:, Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: CO0095075131909COL011610

Write-up: Joint Pain; This spontaneous report was received from a regulatory authority and refers to a 20 (units not provided) female patient. There was no information about the patient''s concurrent conditions, concomitant therapies 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), (frequency, route of administration, anatomical location, lot # and expiration date were not provided) for prophylaxis. On an unknown date, the patient experienced joint pain 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: Arthralgia


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