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This is VAERS ID 836356

Case Details

VAERS ID: 836356 (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: Arthralgia, Death
SMQs:, Arthritis (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: CO0095075131909COL013030

Write-up: ARTHRALGIA; This spontaneous report as received from a regulatory authority refers to a female patient of unknown age (age reported as 9, no units provided).There was no information about the patient''s concurrent conditions, concomitant therapies or medical history provided. On an unknown date the patient was vaccinated with quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine(manufacturer unknown) dose 1000 mg (route, Lot# were not reported.) On an unknown date the patient experienced arthralgia. The patient died on an unknown date. The outcome of arthralgia was fatal. The Agency considered arthralgia to be related to Quadrivalent Human Papillomavirus (Types 6,11,16,18) Recomb. Vaccine(manufacturer unknown).; Reported Cause(s) of Death: ARTHRALGIA


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