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This is VAERS ID 836350

Case Details

VAERS ID: 836350 (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, Multiple sclerosis
SMQs:, Optic nerve disorders (broad), Demyelination (narrow), Immune-mediated/autoimmune disorders (narrow)

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: CO0095075131909COL012183

Write-up: MULTIPLE SCLEROSIS; This spontaneous report has been received from regulatory authority to a female patient (age reported as 16 (units not provided)). No information was provided regarding the patient''s concurrent conditions, concomitant medications or relevant medical history. On an unknown date, the patient was vaccinated with quadrivalent human papillomavirus (Types 6,11,16,18) recomb. vaccine (manufacturer unknown) (dose reported as 0 ml; dose#, route of administration, lot# and expiration date were not reported) for prophylaxis. On an unknown date, the patient experienced multiple sclerosis. On an unknown date, the patient died due to multiple sclerosis. It was unknown if autopsy was performed. The outcome of multiple sclerosis was reported as fatal. The causality between multiple sclerosis and quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (manufacturer unknown) was reported as possible related.; Reported Cause(s) of Death: MULTIPLE SCLEROSIS


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