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This is VAERS ID 836338

History of Changes from the VAERS Wayback Machine

First Appeared on 2/14/2020

VAERS ID: 836338
VAERS Form:2
Age:
Sex:Female
Location:Foreign
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:2019-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPVX: HPV (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Death, Pain in extremity

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': CO0095075131909COL011846

Write-up: LEG PAIN; This spontaneous report as received from a regulatory authority refers to a 16 (units not provided) female patient. The patient''s concurrent conditions, medical history and concomitant medications were not reported. On an unknown date, the patient was vaccinated with quadrivalent human papillomavirus (types 6,11,16,18) recomb. Vaccine (manufacturer unknown) at dose 1 (units not provided) (indication, route of administration, lot# and expiration date were not provided). On an unknown date, the patient died due to leg pain. It was unknown if an autopsy was performed. The reporter considered leg pain to be possibly related to quadrivalent human papillomavirus (types 6,11,16,18) recomb. Vaccine (manufacturer unknown).; Reported Cause(s) of Death: Leg pain

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