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This is VAERS ID 836504

Case Details

VAERS ID: 836504 (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, Depressed level of consciousness
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (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: CO0095075131909COL010868

Write-up: Depression of the central nervous system; This spontaneous report was received from Health authority referring to a female patient. Age was reported as 20(units not reported). The patient''s concurrent condition, medical history and concomitant therapy details were not 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 milliliter (strength, route, lot# and expiry date were not reported) for prophylaxis. On an unknown date, the patient experienced depression of the central and peripheral nervous system (Depressed level of consciousness). The outcome of Depressed level of consciousness was reported as fatal. Cause of death was unknown. It was unknown if an autopsy was performed. The Agency considered Depressed level of consciousness to be possibly related to quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (manufacturer unknown).; Reported Cause(s) of Death: unknown cause of death


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