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This is VAERS ID 836572

Case Details

VAERS ID: 836572 (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 - / -
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: CO0095075131909COL011733

Write-up: depression of the central nervous system; This spontaneous report was received from the Regulatory Health Authority referring to a female patient of unknown age (age: 20 no units reported). The patient''s pertinent medical history, concurrent conditions, concomitant therapies,and past drug reactions/allergies were not reported. On an unknown date, the patient was vaccinated with a dose of quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (strength, dose, route of administration, anatomical location, lot #, and expiration date) for prophylaxis; or with a dose of hpv rl1 6 11 16 18 31 33 45 52 58 vlp vaccine (yeast) (strength, dose, route of administration, anatomical location, lot #, and expiration date) for prophylaxis. On an unknown date, the patient experienced depression of the central nervous system; and then, on an unknown date, she died due to the aforementioned event. It was unknown whether an autopsy was performed or not. The Regulatory Health Authority considered the event depression of the central nervous system to be related to quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine; or related to hpv rl1 6 11 16 18 31 33 45 52 58 vlp vaccine (yeast). The Regulatory Health Authority considered the event syncope as serious (death and medically significant).; Reported Cause(s) of Death: depression of the central nervous system


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