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This is VAERS ID 836344

Case Details

VAERS ID: 836344 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2019-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPVX: HPV (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Death, Pain in extremity
SMQs:, Tendinopathies and ligament disorders (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: CO0095075131909COL011870

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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