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This is VAERS ID 837421

Case Details

VAERS ID: 837421 (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 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Completed suicide, Death
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: CO0095075131910COL000722

Write-up: SUICIDE ATTEMPT; This spontaneous report was received from a regulatory authority and refers to a female patient of unknown age. Her age was reported as 13 (unit not provided). The patient''s pertinent medical history, concomitant therapies, drug reactions and allergies 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 (unit not provided) (lot #, expiry date, anatomical location and route of administration were not provided) for prophylaxis. On an unknown date, the patient attempted suicide, due to which she died on an unknown date. It was unknown whether an autopsy was performed. The regulatory authority did not provide causality assessment. The agency considered this report to be non serious.; Reported Cause(s) of Death: SUICIDE ATTEMPT


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