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This is VAERS ID 836574

History of Changes from the VAERS Wayback Machine

First Appeared on 2/14/2020

VAERS ID: 836574
VAERS Form:2
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 - / 2 - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Death, Autoimmune nephritis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CO0095075131909COL011757

Write-up: Autoimmune nephritis; Information has been received from the Agency on 24-SEP-2019. This spontaneous report has been received from regulatory authority referring to a female patient, age reported as "16". Information regarding the patient''s medical history, drug reactions or allergies, concurrent conditions and concomitant medications was not provided. On an unknown date, the patient was vaccinated with quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine(manufacturer unknown) dose 2 (strength, frequency, route, anatomical location, lot # and expiration date were not provided) for prophylaxis. On an unknown date, the patient experienced autoimmune nephritis (death and medically significant), subsequently, on an unknown date, the patient died. It was not known if an autopsy was performed. The reporter considered autoimmune nephritis to be related to Quadrivalent Human Papillomavirus (Types 6,11,16,18) Recomb. Vaccine(manufacturer unknown). The Agency considered the event to be serious.

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