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This is VAERS ID 836159

History of Changes from the VAERS Wayback Machine

First Appeared on 2/14/2020

VAERS ID: 836159
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 - / UNK - / OT

Administered by: Unknown      Purchased by: ??
Symptoms: Death, Scleroderma

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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CO0095075131909COL010273

Write-up: SCLERODERMIA; This spontaneous report was received from agency on 20-SEP-2019, referring to a 16 unit unknown female patient. The patient''s medical history, concurrent condition and concomitant medication were unknown. On an unknown date the patient was vaccinated with quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (manufacturer unknown) (0 ml, frequency, route, batch/lot number and expiration date were not reported) or hpv rl1 6 11 16 18 31 33 45 52 58 vlp vaccine (yeast) (manufacturer unknown) (0 ml, frequency, route, batch/lot number and expiration date were not reported) for prophylaxis. On an unknown date the patient experienced scleroderma. The event was attributed to vaccination or immunization. On an unknown date the patient died due to the event. It was unknown if an autopsy was performed. The agency considered the event of scleroderma to be possibly related to Quadrivalent Human Papillomavirus (Types 6,11,16,18) Recomb. Vaccine (manufacturer unknown) or HPV rL1 6 11 16 18 31 33 45 52 58 VLP vaccine (yeast) (manufacturer unknown).; Reported Cause(s) of Death: SCLERODERMIA

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