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This is VAERS ID 836579

Case Details

VAERS ID: 836579 (history)  
Form: Version 2.0  
Sex: Female  
Location: Foreign  
Submitted: 0000-00-00
Entered: 2019-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Unknown       Purchased by: ?
Symptoms: Death, Oxygen saturation decreased
SMQs:, Acute central respiratory depression (broad), Respiratory failure (broad), Infective pneumonia (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:
Diagnostic Lab Data:
CDC Split Type: CO0095075131909COL012184

Write-up: Decreased saturation oxygen; This spontaneous report was received from a Regulatory Authority and refers to a female patient of age 16 (units not reported). No information regarding the patient''s medical history, concurrent conditions and concomitant medications were provided. On an unknown date, the patient was vaccinated with quadrivalent human papillomavirus (Types 6,11,16,18) recomb. vaccine (manufacturer unknown) for prophylaxis (dose reported as 1 with units unspecified; strength, route, anatomical location, lot # and expiration date were not reported). On an unknown date, the patient experienced decreased saturation oxygen (oxygen saturation decreased). On an unknown date, the patient died. The cause of death was unknown. It was also unknown if autopsy was performed. No diagnostic results were reported. The Agency considered the event oxygen saturation decreased 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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