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This is VAERS ID 836168

History of Changes from the VAERS Wayback Machine

First Appeared on 2/14/2020

VAERS ID: 836168
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 - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Death, Oxygen saturation decreased

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': CO0095075131909COL011498

Write-up: decreased oxygen saturation; This spontaneous report as received from a regulatory authority on 20-SEP-2019, concerning a "16" (units not reported) old female patient. The patient''s concurrent conditions, medical history and concomitant medications was not provided. On an unknown date, the patient was vaccinated with quadrivalent human papillomavirus (types 6,11,16,18) recomb. Vaccine (QUADRIVALENT HUMAN PAPILLOMAVIRUS (TYPES 6,11,16,18) RECOMB.VACC) (manufacturer unknown), dose: 2 (units not reported) ( dose number, route of administration, anatomical location, lot # and expiration date were not reported) for prophylaxis. On an unknown date, the patient experienced decreased oxygen saturation which resulted in the patient''s death. The agency considered the event of decreased oxygen saturation to be possibly related to quadrivalent human papillomavirus (types 6,11,16,18) recomb. Vaccine (QUADRIVALENT HUMAN PAPILLOMAVIRUS (TYPES 6,11,16,18) RECOMB.VACC) (manufacturer unknown).

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