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This is VAERS ID 837416

Case Details

VAERS ID: 837416 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2019-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPVX: HPV (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Completed suicide
SMQs:, Suicide/self-injury (narrow)

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: CO0095075131910COL000394

Write-up: suicide; This spontaneous report was received from a Regulatory Authority and refers to a female patient, age reported as 13 (units were not reported). Her concurrent conditions, medical history and concomitant medications 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 4 (units were not provided) (route of administration, anatomical location, lot number and expiry date were not provided) for prophylaxis. On an unknown date, the patient committed a suicide (reported as event attributable to vaccination or immunization). The outcome of suicide was fatal. It was not specified if autopsy was performed. The relatedness between the suicide and quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (manufacturer unknown) was not reported.


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