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This is VAERS ID 836445

Case Details

VAERS ID: 836445 (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, Gait inability
SMQs:, Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (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: CO0095075131909COL012260

Write-up: UNABLE TO WALK; Information was received from the Health Authority concerning a female patient. Her age was reported as 20 (units were not provided). No concurrent condition, medical history, or concomitant therapy was reported. 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"; strength, frequency, route, indication and lot# were not reported). On an unknown date, the patient was unable to walk. The outcome of the event was reported as fatal. The date of the patient''s death was unknown. It was not provided if the autopsy was performed or not. The action taken with suspect therapy regarding the event was not reported. The event was considered to be serious by the agency. The reporter considered the event to be possibly related to Quadrivalent Human Papillomavirus (Types 6,11,16,18) Recomb. Vaccine (manufacturer unknown).; Reported Cause(s) of Death: Unable to walk


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