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|Vaccination / Manufacturer||Lot / Dose||Site / Route|
|HPVX: HPV (NO BRAND NAME) / UNKNOWN MANUFACTURER||- / UNK||- / -|
Administered by: Unknown Purchased by: ??
Symptoms: Death, Cardiopulmonary failure
Life Threatening? No
Birth Defect? No
Permanent Disability? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Diagnostic Lab Data:
CDC 'Split Type': CO0095075131909COL010881
Write-up: Cardiorespiratory failure; Information has been received from the Regulatory Authority (2019PVCL1099) on 20-SEP-2019, concerning to female patient of 16 age (units not provided); The patient''s pertinent concurrent conditions, concomitant therapies, drug reactions and allergies were not provided. On an unknown date, the patient was vaccinated with quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (manufacturer unknown), or hpv rl1 6 11 16 18 31 33 45 52 58 vlp vaccine (yeast) (manufacturer unknown), dose reported as two (units not provided) for prophylaxis (the concentration, frequency, route and anatomical location of administration, lot number and expiration date were not reported). On an unknown date, the patient experienced cardiorespiratory failure and died It was unknown if an autopsy was done. The causality assessment between HPV rL1 6 11 16 18 31 33 45 52 58 VLP vaccine (yeast) (manufacturer unknown) and Quadrivalent Human Papillomavirus (Types 6,11,16,18) Recomb. Vaccine (manufacturer unknown) and cardiopulmonary failure was reported as possible by the Health Authority.; Reported Cause(s) of Death: Cardiorespiratory failure
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