Reports of Deaths

2.13.
2010
Section VII - Why did my daughter die?
Reports of Deaths
VAERS HPV4
ID Date Age Onset days
01) 275428 2007-03-08 12 6 COD as acute myocarditis, presumably viral. Received final Autopsy Report which
reveals COD as acute probable viral etiology myocarditis & manner of death as
natural.
02) 275438 2007-03-26 19 14 Death Certificate COD is sudden cardiac death and pulmonary embolism.
Echocardiogram revealed very enlarged right ventricle & small left ventricle as well
as large blood clots within both the right atrium & right ventricle
03) 275990 0000-00-00 00 Unknown Thrombosis
04) 278865 2007-03-16 15 1 COD asmultiorgan system failure and influenza B viral sepsis with contributing cause
of staphyloccoccal secondary infection.
05) 279592 0000-00-00 00 Unknown Thrombosis
06) 280163 2007-05-04 11 3 Anaphylactic reaction, Cardiac arrest.
07) 282372 2007-06-01 17 0 Sudden death
08) 282747 0000-00-00 00 Unknown Unknown
09) 287888 2007-05-23 22 2 Sudden death
1 Prepared by Janny Stokvis

10) 291804 2007-09-19 17 50 Diabetic ketoacidosis & manner of death natural
11)` 293388 2007-10-08 18 115 Received death certificate from funeral home which states COD as brain death due to
cerebral herniation and meningoencephalitis.
12) 297528 2007-10-06 12 21 Died in her sleep
13) 299377 2007-10-12 16 16 Died in her sleep
14) 300066 2007-11-25 26 13 COD as pulmonary thromboembolus w/deep vein thrombosis of right leg & obesity
as contributing factor.
15) 305606 2008-02-22 17 2 Sudden death Autopsy report states COD asundetermined. A
16) 307394 2009-03-15 13 85 Possible motor neuron disease
17) 309233 2007-06-29 12 56 The patient's cause of death was prolonged QT syndrome, brain death, and
proguda syndrom
18) 310262 2008-04-05 20 4 cause of death is undetermined.
19) 316983 2008-06-12 17 15 idiopathic seizure disorder, Reviewed ER medical records of 6/12/2008. Records
reveal patient found unresponsive, prone on her bed when parent went to awake for
school.
20) 317695 2008-06-26 42 2 Unknown
21) 317757 2008-06-15 15 2 Arrhythmia due to cardiomyopathy

22) 318244 0000-00-00 20 Unknown pulmonary embolism with fatal outcome
23) 318491 0000-00-00 00 Unknown allergic reaction to GARDASIL
24) 319533 2008-06-20 21 17 Cardiac arrest, cause undetermined
25) 319810 2007-09-20 15 45 COD: Seizure Disorder
26) 320559 0000-00-00 00 (unverified)??
27) 320909 0000-00-00 21 Unknown cause of death "viral insult to the heart"
28) 320910 0000-00-00 00 Unknown Unknown
29) 321696 2008-04-07 16 3 Seizures, Cardiac arrest, cause unknown
30) 322250 0000-00-00 22 Unknown Unknown
31) 323430 2008-08-21 20 263 Autopsy states COD as unclassified neurologic process, clinically presumed to be
atypical GBS vs bulbar varient of ALS.
32) 324002 2008-03-12 16 15 Cause of Death: cardiovascular collapse as a consequence of pulmonary emboli,
dehydration and diabetic ketacidosis.
33) 325063 2008-08-04 17 8 myocarditis & CHF as contributing factor
34) 325151 2008-08-21 20 266 muscle weakness in throat and breathing
35) 334611 2008-12-08 19 12 Found dead in her bed. COD Unkmown
36) 335270 2008-07-16 18 86 ruptured cerebral aneurysm Autopsy on-going

37) 337242 2008-11-15 20 COD-undetermined
38) 337797 2007-08-31 18 240 COD-undetermined by autospy and toxicology
39) 338452 German report about German girl. Database PEI
40) 338561 2009-01-01 20 5 An autopsy was performed (unspecified date) and found no cause of death, also
reported as information on autopsy was still awaited
41) 339771 2008-10-26 13 181 autopsy report received immediate cause:Massive pulmonary embolism. Mild
cardiomegaly. Last several days C/O cough and congestion. 3/9/09-ED records
received for DOS 10/26/08 -presented in full cardiac arrest after suffering a full and
prolonged cardiac arrest, aystole
42) 341030 0000-00-00 14 Unknown Unknown
43) 343612 2008-11-26 23 25 hypertrophic cardiomyopathy
44) 343777 0000-00-00 11 Unknown Unknown
45) 344160 2009-04-03 11 4 Autopsy report received COD Necrotizing Fasciitis (Gram (+)) with septic shock.
46) 344385 0000-00-00 16 Unknown Unknown
47) 345435 0000-00-00 21 4 Unknown
48) 346674 0000-00-00 12 Unknown
49) 350666 0000-00-00 00 Unknown Unknown
50) 350967 0000-00-00 00 (unverified)??

51) 350968 0000-00-00 00 (unverified)??
52) 351970 2009-06-22 37 45 Meningitis or other??
53) 350228 2009-06-12 14 3 asthmatic attack of which she died
54) 356938 2008-09-12 19 53 Acute Cardiac Arrhythmia of Unknown Etiology.
55) 361121 0000-00-00 00 (unverified)??
56) 361629 0000-00-00 00 Hearsay report!

57) 373314 0000-00-00 23 (unverified)??
58) 373315 0000-00-00 00 Hearsay report!
59) 372910 2009-09-22 18 189 Sudden death
60) 374780 0000-00-00 14 (unverified)??
61) 375036 2001-27-15 17 50 An autopsy was carried out, but the result was notknown to the reporter at
time of reporting
VAERS HPV2 Report from the UK
62) 363051 2009-09—28 14 0 Anaphylactic reaction, Cardiac arrest

Germany Paul-Ehrlich-Institut HPV4
63) 8567 2007-05-22 17 Sudden unexplained death.
64) 9747 2007-10-.. 19 Sudden unexplained death
65) 10528 2008-08-16 20 Myocarditis, Pulmonary Embolism
66) 11802 2008-12-29 15 Carbon Monoxide poisoning (VAERS ID 338452)
67) 12908 2009-06-12 14 Cardiac arrest
New Zealand
Age
68) No access to report 18 Sudden death

VAERS ID: 275428 Vaccination Date: 2007-03-01 Life Threatening Illness? No
Age: 12.0 Onset Date: 2007-03-07 Days later: 6 Died? Yes (date died: 2007-03-08)
Gender: Female Submitted: 2007-04-02 Disability? No
State: New York Entered: 2007-04-02 Recovered? No
Vaccination Manufacturer Lot Dose Route Site ER or Doctor Visit? No
HEPA MERCK & CO. INC. 1280F 1 IM RA Hospitalized? No
HPV4 MERCK & CO. INC. 0263U 0 IM LA Current Illness: none
VARCEL MERCK & CO. INC. 0943R 1 SC RA Diagnostic Lab Data: ER LABS of 3/8/07:
ABG pH 7.23, po2 62. Serum glucose 353, Creat
Administered by: Unknown Purchased by: Unknown 1.7, albumin 2.6, total protein 4.9, SGPT 62,
Symptoms: Abdominal pain, Acidosis, Alanine aminotransferase increased, Aspartate SGOT 359. Blood c/s was neg. 2005 Cardiology
aminotransferase increased, Autopsy, Blood albumin decreased, Blood creatinine increased, LABS: echocardiogram revealed mild mitral
Blood culture negative, Blood gases abnormal, Blood glucose increased, Cardiomegaly, valve & aortic valve insufficiency. Mi
Chest X-ray abnormal, Cough, Echocardiogram abnormal, Gastroenteritis, Mitral valve Previous Vaccinations:
incompetence, Myocarditis, Nervousness, Oxygen saturation decreased, Palpitations, Protein Other Medications:
total decreased, Pyrexia, Rhinorrhoea, Ventricular tachycardia, Viral myocarditis Preexisting Conditions: aortic and mitral valve
Write-up: presented to ED with Ventricular tachycardia. Preliminary autopsy finding of insufficiency, unknown aetiology
myocarditis. 4/3/07 Spoke w/ME who stated prelim COD as acute myocarditis, presumably
CDC 'Split Type':
viral. States patient had PMH of heart murmur which was evaluated by ped cardiologist who

found mild aortic & mitral valve insufficiency & regurgitation. ME states did not see
evidence of that on autopsy but did find cardiomegaly. Also states patient had been taken to
ER on day of death for abdominal pain w/fever & was dx w/gastroenteritis. CXR at that time
revealed cardiomegaly. No EKG or cultures were done. Was d/c to home & continued to not
feel well. Parent found patient in bathroom unresponsive at approx 2AM & was transported
to a second ER where she expired. ME states patient had approx 2 week hx of cough &
runny nose prior to death. 6/12/07 Received final Autopsy Report which reveals COD as
acute probable viral etiology myocarditis & manner of death as natural. 6/29/07 Received ER
records from hospital where patient expired which reveal patient was in respiratory arrest &
had been intubated by EMS. ACLS measures were unsuccessful & patient pronounced.
8/24/07 Received cardiology consult which reveals patient evaluated for heart murmur in
2005 which had been diagnosed for long time but never evaluated. Patient admitted to
palpitations & nervousness. Patient history did not reveal any evidence of rheumatic fever.
Antibiotic endocarditis prophylaxis recommended prior to dental & surgical procedures.
Patient was to f/u w/cardiology in 2-3 yearrs to document progress of valvular insufficiency.
FINAL Cardiology DX: Aortic & mitral valve insufficiency of unknown etiology.

VAERS ID: 275438 Vaccination Date: 2007-03-12
Age: 19.0 Onset Date: 2007-03-26 Days later: 14 Life Threatening Illness? No
Gender: Female Submitted: 2007-04-02 Died? Yes (date died: 2007-03-26)
State: California Entered: 2007-04-02 Disability? No
Recovered? No
Vaccination Manufacturer Lot Dose Route Site
ER or Doctor Visit? Yes
HPV4 MERCK & CO. INC. 0263U 0 IM LA
Hospitalized? No
Administered by: Other Purchased by: Other Current Illness: None
Symptoms: Convulsion, Cor pulmonale, Coronary artery thrombosis, Echocardiogram Diagnostic Lab Data: echocardiogram,
abnormal, Pulmonary congestion, Pulmonary embolism, Pulmonary oedema, Sudden cardiac 03/26?/07, very enlarged right ventricle and
death, Thrombosis small left ventricle as well as large blood clots
Write-up: Given Gardasil vaccine dose #1 3/12/07. No adverse reaction reported. Collapsed (see narrative)
and died on 3/26/07 secondary emboli (records unavailable). 4/3/07 Spoke w/investigating Previous Vaccinations:
deputy who stated autopsy done at Medical Center. T/C to physician at Medical Center who Other Medications: Yasmin birth control pills;
is actually a cardiologist, not pathologist, who had responded to the code & pronounced. hormal contraceptives
Spoke w/secretary who states from Death Certificate COD is sudden cardiac death and
Preexisting Conditions: None PMH:
pulmonary embolism. Echocardiogram revealed very enlarged right ventricle & small left
contraception; Non-smoker
ventricle as well as large blood clots within both the right atrium & right ventricle. 6/25/07
Received Autopsy Report which reveals following anatomic diagnosis: 1. Pulmonary CDC 'Split Type': WAES0705USA05011
embolism, occlusive a. pulmonary trunk, left hilar & peripheral vessels b. acute cor

pulmonale (by echocardiogram) 2. Pulmonary congestion & edema, bilatera a. no evidence
of anomalous coronary artery distribution b. no evidence of ventricular dysplasia This is in
follow-up to report(s) previously submitted on 6/11/2007. Information has been received on
request from the FDA under the Freedom of Information Act and from a physician who
presented at the "Global Advisory Committee on Vaccine Safety World Health
Organizaqtion" concerning a 19 year female nonsmoker with no history who on 12-MAR-
2007 was vaccinated IM into the left arm with a first dose of GARDASIL lot
#655849/0263U). Concomitant therapy included oral contraceptives. There was no adverse
reaction reported. Subsequently on 26-MAR-2007 the patient, while exercising on a field
collapsed, began convulsing and died secondary to emboli. An autopsy was done and on the
death certificate the following is documented "sudden cardiac death and pulmonary
embolisem." An Echocardiogram revealed a very enlarged right ventricle and small left
ventricle as well as large blood clots within both the right atrium and right ventricle.
Coronary artery thrombosis and thrombosis were alsor reported. Upon internal review
convulsing was considered an other important medica

Life Threatening Illness? No
Age: Onset Date: 0000-00-00 Days later:
Died? Yes (date died: 0000-00-00)
Gender: Female Submitted: 2007-04-10
Disability? No
State: Unknown Entered: 2007-04-11
Recovered? No
Vaccination Manufacturer Lot Dose Route Site ER or Doctor Visit? Yes
HPV4 MERCK & CO. INC. UN Hospitalized? No
Administered by: Other Purchased by: Other Current Illness:
Symptoms: Death, Thrombosis Diagnostic Lab Data: Unknown
Write-up: Information has been received from a physician's assistant (PA), via a company Previous Vaccinations:
representative, concerning a female patient who was vaccinated (date unspecified) with a Other Medications: Unknown
dose of Gardasil the PA reported that "the patient died of a blood clot 3 hours after getting Preexisting Conditions: Unknown
the Gardasil vaccine." The PA clarified that the patient was not vaccinated at her office. CDC 'Split Type': WAES0704USA00721
Additional information has been requested.

VAERS ID: 278865 Vaccination Date: 2007-03-02 Life Threatening Illness? Yes
Age: 15.0 Onset Date: 2007-03-01 Days later: -1 Died? Yes (date died: 2007-03-16)
State: Arizona Entered: 2007-05-17 Recovered? No
Hospitalized? Yes, 10 days
HPV4 MERCK & CO. INC. 1424F 1 IM LA
Extended hospital stay? No
Administered by: Unknown Purchased by: Unknown Current Illness:
Symptoms: Acute respiratory distress syndrome, Blood culture positive, Chest pain, Cough, Diagnostic Lab Data: Influenza B isolated by
Culture throat negative, Culture urine negative, Influenza, Mechanical ventilation, Multi- viral culture. Specimen sent to CDC for antigenic
organ failure, Myalgia, Nasal congestion, Pharyngolaryngeal pain, Pneumonia characterization. LABS: Throat & urine c/s neg.
staphylococcal, Pyrexia, Respiratory failure, Rhinorrhoea, Sepsis, Staphylococcal infection, Blood & endotrachael c/s + for MRSA. Nasal
Streptococcal identification test, Viral test swab + for influ B virus. Lymph node c/s were
Write-up: Onset of symptoms on 3/1/07: fever, sore throat, cough, and myalgia. Respiratory neg. from PCP office, St
failure on 3/6/07. 6/1/07 Received Death Certificate from epidemiologist which reveals COD Previous Vaccinations:
asmultiorgan system failure and influenza B viral sepsis with contributing cause of Other Medications: Topamax
staphyloccoccal secondary infection. Medical records included w/death certificate indicate
patient was transferred to higher level of care on 3/6, was intubated & in PICU w/pneumonia Preexisting Conditions: PMH: migraine
& ARDS. Reportedly had been in good health until 3/1/07 when she developed sore throat, headaches. Family HX: younger sister also
nasal congestion, rhinnorhea & low grade fever. COntinued to worsen & developed w/strep neg sore throat. Letter from school that
myalgias, chest pain & nonproductive cough w/higher fever. Seen by PCP on 3/5 & rapid group A strep infections present.
strep was neg & dx was probable influenza. Sent home & developed nausea, vomiting & CDC 'Split Type':

diarrhea as well as petechial rash over abdomen. Taken to outlying ER on 3/6 & found to be
in respiratory failure, intubated & transferred to higher level of care. Respiratory status
declined further & was placed on oscillator & ECMO. Peds ID consult done. Consult states
had HPV vax at PCP on 3/2 & no other recent vaccines. 6/1/07 Received fax medical &
vaccine records from CDC who had contacted provider. Reveals that on 1/2/07, patient
received TDaP & HPV. On 3/2/07 received HPV #2. VAERS database updated w/same. On
day of vax patient also dx w/right CTS, migraine HA, scoliosis. She was referred to Neuro &
PT for the CTS & HA.

Age: Onset Date: 0000-00-00 Days later: Life Threatening Illness? Yes
State: Unknown Entered: 2007-05-24 Disability? Yes
Recovered? No
HPV4 MERCK & CO. INC. UN UN
Hospitalized? No
Symptoms: Death, Thrombosis Diagnostic Lab Data:
Write-up: Information has been received from a licensed visiting nurse via a nurse Previous Vaccinations:
practitioner. The nurse practitioner was told by a friend that a female patient was vaccinated Other Medications: Unknown
with Gardasil and two weeks alter developed a blood clot. Subsequently the patient died. The
cause of death was from the blood clot. The reporting licensed visiting nurse considered the Preexisting Conditions: Unknown
blood clot to be immediately life-threatening and disabling. Additional information has been CDC 'Split Type': WAES0705USA01964
requested.

Age: 11.0 Onset Date: 2007-05-04 Days later: 3
Life Threatening Illness? Yes
Disability? No
Vaccination Manufacturer Lot Dose Route Site Recovered? No
HPV4 MERCK & CO. INC. 0 UN UN ER or Doctor Visit? Yes
Hospitalized? No
Administered by: Other Purchased by: Other
Current Illness:
Symptoms: Anaphylactic reaction, Cardiac arrest, Death
Diagnostic Lab Data:
Write-up: Information has been received from a nurse practitioner who heard from an
emergency room (ER) nurse that an 11 year old female was vaccinated "within in the past Previous Vaccinations:
month" in approximately May 2007 with a first dose of Gardasil. Subsequently, 3 days after Other Medications: Unknown
vaccination the patient presented to an ER. She experienced cardiac arrest, required lung Preexisting Conditions: Unknown
bypass (ECMO) and "may not have expired." It was also reported by the same nurse that the CDC 'Split Type': WAES0705USA04839
physician from the hospital said that "the death was due to an anaphylactic reaction to
Gardasil." The anaphylactic reaction and cardiac arrest were considered to be life threatening
by the reporter. Additional information has been requested.

Gender: Female Submitted: 2007-06-19 Life Threatening Illness? No
State: Entered: 2007-06-20 Died? Yes (date died: 0000-00-00)
Vaccination Manufacturer Lot Dose Route Site Disability? No
HPV4 MERCK & CO. INC. 0 UN UN Recovered? No
ER or Doctor Visit? No
Administered by: Unknown Purchased by: Unknown
Hospitalized? No
Symptoms: Autopsy, Loss of consciousness, Resuscitation, Sudden death
Current Illness:
Write-up: Information has been received from a gynecologist who was informed of the case
Diagnostic Lab Data: Unknown
from another gynecologist concerning a 17 year old female who in June 2007 (week 23), was
vaccinated with a first dose of Gardasil (lot number, injection site and route not reported). Previous Vaccinations:
During the evening of the same day, the patient was found unconscious (lifeless) by the Other Medications: Unknown
mother. Resuscitation was performed by the emergency physician but was unsuccessful. The Preexisting Conditions: Dental operation
patient subsequently died. The cause of death was sudden death. It was noted that the patient CDC 'Split Type': WAES0706USA02451
had a dental surgery the day before she was vaccinated. An autopsy was done. The results
were not known. Other business partner numbers include E2007-03769. Additional
information has been requested.

Gender: Submitted: 2007-06-22
Disability? No
Recovered? No
HPV4 MERCK & CO. INC. UN UN Hospitalized? No
Symptoms: Death Diagnostic Lab Data: Unknown
Write-up: Information has been received from a physician who attended a conference that Previous Vaccinations:
mentioned two patients who were vaccinated with Gardasil. Subsequently the patients died. Other Medications: Unknown
The cause of death not reported. Attempts are being made to obtain additional identifying Preexisting Conditions: Unknown
information to distinguish the individual patients mentioned in this report. Additional CDC 'Split Type': WAES0706USA02351
information will be provided if available. Additional information has been requested.

State: Unknown Entered: 2007-08-13 Died? Yes (date died: 2007-05-23)
Disability? No
Recovered? No
HPV4 MERCK & CO. INC. 0389U IM UN ER or Doctor Visit? Yes
Administered by: Other Purchased by: Other Hospitalized? No
Symptoms: Adverse drug reaction, Autopsy, Death, Drug screen positive Current Illness:
Write-up: Information has been received from a nurse practitioner concerning a 22 year old Diagnostic Lab Data: autopsy - no findings
female patient with no pertinent medical history or drug allergies who on 21-MAY-2007, Previous Vaccinations:
was vaccinated IM with a 0.5ml dose of Gardasil (Lot# 657736/0389U). Concomitant Other Medications: hormonal contraceptives
therapy included hormonal contraceptives (unspecified) ("MERCET"). On 23-MAY-2007,
the patient died suddenly. The cause of death was unknown. Unspecified medical attention Preexisting Conditions: None 7/2/08-records
was sought. Laboratory diagnostic studies included an autopsy which showed no findings. received-HX of heroin and prescription drug
No product quality complaint was involved. The reporter stated that Gardasil did not cause abuse.
the patient's death. Additional information is not expected. 7/2/08-records received-Adverse CDC 'Split Type': WAES0708USA00407
effect of drugs.Toxicology survey findings:urine positive for methadone, benzodiazepines,
benzoylecgonine (from cocaine), cannabinoids, nicotine, diphenhydramine and naproxen.

State: Ohio Entered: 2007-10-02 Died? Yes (date died: 2007-09-19)
HPV4 MERCK & CO. INC. 1427F 1 UN LA Recovered? No
Administered by: Other Purchased by: Other Hospitalized? No
Symptoms: Blood glucose increased, Death, Diabetic ketoacidosis, Pulse absent, Current Illness: IDDM, uncontrolled. Smoker.
Resuscitation, Unresponsive to stimuli, Vomiting anemia.
Write-up: Information has been received from a physician concerning a female who on an Diagnostic Lab Data: Unknown Vitreous
unknown date was vaccinated with the first dose of Gardasil (yeast, unknown lot number) glucose 667 (H).
and in July 2007, was vaccinated with the second dose of Gardasil. In September 2007, the
patient died. No further details or symptoms were known regarding the patient's death. The Previous Vaccinations:
physician mentioned that an autopsy would be done however, had not received the results Other Medications: Unknown
yet. The reporting physician felt that the patient's death was not related to therapy with Preexisting Conditions: Unknown PMH:
Gardasil. Additional information has been requested. 10/11/2007 Patient demographics IDDM, uncontrolled. Smoker. Right buttock
provided by CDC. 10/15/07 Received vax record from pcp. VAERS database updated abscess 8/31/07. Anemia. Father w/diabetes.
w/same. 10/15/07 Received pcp & hospital medical records from CDC which reveal patient ALLERGIES: PCN, cipro, ultram (hives).
experienced vomiting with elevated blood sugars who became unresponsive & pulseless. CDC 'Split Type': WAES0709USA04400
CPR started & taken to ER on 9/19/07. Resuscitation was unsuccessful & patient pronounced
9/19/07. 10/26/07 Reviewed autopsy report which reveals COD as diabetic ketoacidosis &
manner of death as natural. Patient had been found by parent unresponsive at home. History

of severe diabetes mellitus. Vitreous glucose 667 (H).

Disability? No
State: New York Entered: 2007-10-17
Recovered? No
HPV4 MERCK & CO. INC. 0389U 1 UN RA Hospitalized? No
Symptoms: Alanine aminotransferase decreased, Back pain, Blood creatinine increased, Diagnostic Lab Data: 07/Oct/2007: Brain CT
Blood culture negative, Brain death, Brain herniation, Brain oedema, Bronchoscopy, C- showed meningococcal disease ER LABS: CT
reactive protein increased, CSF culture positive, CSF glucose decreased, CSF neutrophil scan & CXR WNL. WBC 14.9 (H), Neutros 87.2
count increased, CSF pressure increased, CSF protein increased, CSF white blood cell count (H), lymphs 6.4 (L). Creatinine 1.2 (H), ALT 27
increased, Chest X-ray normal, Chills, Computerised tomogram abnormal, Culture urine (L). CSF WBC 4455 (H), RBC 171 (H), neutros
negative, Death, Echocardiogram normal, Encephalitis, Headache, Intubation, Lumbar 100% (H), glucose 29 (L), protein 371
puncture, Lymphocyte count decreased, Malaise, Meningitis meningococcal, Mydriasis, Previous Vaccinations:
Nausea, Neck pain, Neutrophil count increased, Pallor, Photophobia, Posturing, Pupil fixed, Other Medications:
Pyrexia, Red blood cells CSF positive, White blood cell count increased Preexisting Conditions: Medical history and
Write-up: This case was received from a health care professional on 10 October 2007. concomitant medications not reported; it was
Additional information was received from a newspaper article. An 18-year-old female unknown if the patient was ill at time of
patient received a meningococcal vaccine (name, manufacturer, and lot number not reported) vaccination.
on an unspecified date. The patient, who was a college freshman, travelled on 05 October CDC 'Split Type': 200703414
2007 to visit her family for the weekend. She reportedly felt "slightly ill" upon her arrival,

and subsequently took an aspirin and went to bed, awakening at 1:30pm the following
afternoon 'appearing refreshed". She became feverish again that night, and awoke at 1:00am
the morning of 07 October 2007 with chills and a severe headache, complaining that "my
head is about to explode". She was taken to a local hospital, where a CAT scan of the brain
revealed meningococcal disease in her brain and brain stem. She was immediately
transferred to another hospital, and died that evening of 07 October 2007 due to
complications of meningitis. The health department noted that "lab tests have not yet
confirmed the strain of meningitis" but that it was "likely the type not prevented by the
vaccination". Past medical history and concomitant medications were unknown: it was not
known if the patient was ill at the time of vaccination. 10/18/07 Patient name received from
FDA. 10/18/07 Received death certificate from funeral home which states COD as brain
death due to cerebral herniation and meningoencephalitis. 10/26/07 Received vax record
from pcp which indicates patient received HPV & Menactra on 5/10/2007. VAERS database
updated w/same. Vax record indicates patient also received 2nd dose of HPV 6/13/2007, Lot
# 0523U, left arm. 11/27/07 Reviewed hospital medical records which reveal patient
experienced HA, fever & neck pain x 1 day. Had come home from college 10/5 & developed
chills next day. Seen in outlying ER where LP showed high pressure, grossly purulent CSF
growing meningococcus. Intubated & IV antibiotics started & transferred to higher level of
care. Neurosurgery & ID consults don

Age: 12.0 Onset Date: 2007-10-06 Days later: 21 Life Threatening Illness? Yes
State: Unknown Entered: 2007-11-23 Disability? No
Recovered? No
Hospitalized? No
Write-up: Information has been received from a physician's assistant concerning a 12 year Previous Vaccinations:
old female with no reported medical history who on approximately 15-SEP-2007 was Other Medications: Unknown
vaccinated with Gardasil. It was noted that this was not where the vaccine was administered,
rather they were the patient's family physician. On 06-OCT-2007 the patient died in her Preexisting Conditions: Unknown
sleep. No further information was provided. No lot number was given. Additional CDC 'Split Type': WAES0711USA02619

State: Entered: 2007-12-12
Vaccination Manufacturer Lot Dose Route Site Died? Yes (date died: 2007-10-12)
HPV4 MERCK & CO. INC. 1475F 0 UN UN Disability? No
Recovered? No
Symptoms: Bronchitis, Death, Diarrhoea, Photophobia
Hospitalized? No
Write-up: Information has been received from a gynecologist concerning a 19 year old
female with no previous medical history reported, who on 19-SEP-2007 was vaccinated Current Illness:
(route and site not reported) with the 1st dose of Gardasil (Batch# NF37120, lot#1475F). On Diagnostic Lab Data: Unknown
the morning of 12-OCT-2007, the patient was found dead in her bed. One week prior to Previous Vaccinations:
death the female suffered from diarrhea, treatment without antibiotics. The patient also Other Medications: Unknown
developed light sensitivity. The evening before the patient died she was out with a girlfriend
until 3:00 am in the morning. The reporting physician excluded any drug misuse, as she Preexisting Conditions: None
knew the female as a sportive young woman. Contraception was stopped 3 months before CDC 'Split Type': WAES0712USA01347
vaccination. No reason for the death was detected in autopsy. The only finding in the autopsy
was mild bronchitis and mucus. The reporting physician excluded any connection between
vaccination and death. Other business partners numbers include E2007-08849(0). Additional
information is not expected.

Age: 26.0 Onset Date: 0000-00-00 Days later: Died? Yes (date died: 2007-11-25)
State: Texas Entered: 2007-12-17 Recovered? No
HPV4 MERCK & CO. INC. 0106U 1 UN UN Hospitalized? No
Current Illness: Obesity
Administered by: Other Purchased by: Other Diagnostic Lab Data: Unknown
Symptoms: Death, Deep vein thrombosis, Obesity, Pulmonary embolism Previous Vaccinations:
Write-up: Information has been received from a physician concerning a large female who Other Medications: Unknown
received one dose of Gardasil. Subsequently, the patient was found dead in her truck from a
blood clot that traveled from her legs to her lungs. The cause of death was reported to be a Preexisting Conditions: Asthma, morbid
blood clot. Additional information has been requested. 3/5/08 Autopsy states COD as obesity, smoker, occasional ETOH. OCP
pulmonary thromboembolus w/deep vein thrombosis of right leg & obesity as contributing unknown
factor. CDC 'Split Type': WAES0712USA02658

State: New York Entered: 2008-02-25
HPV4 MERCK & CO. INC. 1968U 2 IM LA
Disability? No
Administered by: Private Purchased by: Other Recovered? No
Symptoms: Arrhythmia, Electrocardiogram QT prolonged, Fall, Laceration, Sudden death ER or Doctor Visit? No
Write-up: Sudden unattended death. Autopsy results pending (inconclusive 2/25/08). Hospitalized? No
2/26/08 Reviewed pcp medical records & vax records which reveal patient received HPV#1 Current Illness:
0469U 7/16/07 & HPV#2 09300 9/17/07. In 11/20/07, noted to have left sided head pain
intermittently along with lightheadedness; dx w/tension HA. HPV#3 was scheduled for
1/16/2008 but postponed due to no parental signature. Returned to office 1/24/08 for left Previous Vaccinations:
wrist pain from cheerleading injury s/p ER vs for same on 1/19/08. Patient last seen in office Other Medications: Yasmin daily birth control
by nurse only on 2/20 for HPV #3, no notes for visit. PMH: kicked in face by horse in past Preexisting Conditions: No known drug
(undated) & had contusion on cheek; acne vulgaris, started Yasmin & topicals 4/07 allergies
w/improvement after multiple other drug failures; 1/19/08 wrist contusion from cheerleading. CDC 'Split Type':
5/2/08 Autopsy report states COD as undetermined. Autopsy states patient had intermittent
HAs x 2 mo & had been on BCP x 1 year for acne. Found w/small facial laceration from
striking flower pot when fell. The autopsy was neg for all findings. Scene indicated sudden
death from collapse & fall. Suspected long QT interval syndrome w/fatal arrhythmia rather
than new onset seizure in patient w/no history of either. Suggested testing family members.

Gender: Female Submitted: 2008-03-19 Disability? Yes
State: California Entered: 2008-03-19 Recovered? No
HPV4 MERCK & CO. INC. 0187U 2 Hospitalized? Yes, 24 days
Extended hospital stay? Yes
Administered by: Unknown Purchased by: Unknown Current Illness: none
Symptoms: Activities of daily living impaired, Asthenia, Blood creatine phosphokinase Diagnostic Lab Data: EMG and nerve
increased, Blood immunoglobulin M increased, Blood product transfusion, Blood conduction studies suggest motor neuronopathy
triglycerides increased, Bronchopneumonia, CSF lymphocyte count increased, CSF vs neuropathy 4/8/09-records received- EEG
monocyte count decreased, CSF protein increased, Convulsion, Demyelination, Dyspnoea, normal. MRI brain showed slightly prominent
Dysstasia, Electroencephalogram normal, Electromyogram abnormal, Gait disturbance, cerebellar fissures but otherwise normal. MRI
Gastrostomy tube insertion, Headache, Hepatic steatosis, Hepatitis B antibody negative, spine normal. West Nile, hepatitis B were nega
Hypercalcaemia, Hypoxia, Limb injury, Lower motor neurone lesion, Mechanical
ventilation, Motor neurone disease, Muscle atrophy, Muscular weakness, Nausea, Nerve Previous Vaccinations:
conduction studies abnormal, Neuropathy, Nuclear magnetic resonance imaging brain Other Medications: none
abnormal, Paralysis flaccid, Plasmapheresis, Postictal state, Respiratory failure, Sleep apnoea Preexisting Conditions: none 4/8/08-recor ds
syndrome, Tremor, Urinary incontinence, Urine analysis abnormal, Urine lactic acid received-PMH: attention deficit hyperactivity
increased disorder and congenital strabismus. Migraines.
Write-up: progressive muscle weakness resulting in flaccid paresis of all 4 extremities, Cognitive delay, developmental delay and motor
respiratory insufficiency 4/8/08-records received for DOS 2/4-2/17/08-DC DX: autoimmune delay. Allergies:strawberries cause an itch. In
motor neuropathy, provisional. Possible motor neuron disease. Admission 3/14-3/25/08-DC May sustained injury with pain in leg which
DX: Muscular weakness. Seizures. Received IVIG, treated with plasmapheresis.Admitted improved but never returned completely to
with C/O progressive muscular weakness over the 3 weeks prior to admission increased normal. 4/16/08-records received-PMH:

immunomodulation. Seizure after completion of solumedrol. Remained post ictal for several Pityriasis lichennoides. Allergy to strawberries
hours. No diagnosis made during this admission.Genetic evaluation for mitrochondrial CDC 'Split Type':
disease sent to include evaluation for Pompe disease. In May sustained injury with pain in
leg which improved but never returned completely to normal. Developed worsening limping
and loss of strength in distal left lower extremity. Between August and October of 2007
developed symptoms in right arm. Received IVIG at that time and again January 2008 with
improvement in right handed tremor but worsening function status especially in ambulation,
stair climbing and standing from seated position. Feb 4-17 2008 hospitalized received
plasmapheresis with improved ability to stand for short periods. C/O headaches and nausea.
She may have chronic inflammatory demyelinating myopathy versus a multifocal motor
neuropathy. After discharge to follow up with specialist in ALS. 4/16/08-records received-
for DOS 1/2-1/3/08-DC DX: Multifocal neuropathy versus chronic demyelinating
polyneuropathy. LP: mildly elevated protein of 46 with normal glucose. Unable to perform
activities of daily living. IVIG treatment. PE: left lower and right upper extremity weakness
and atrophy with some mild weakness of right lower extremity. 4/16/08-clinical consult case
review template received: CPK increased of 313 and slightly elevated anticardiolipin IgM of
20.3. DX: chronic inflammatory demyelinating polyneuropathy. 1/2/08-urinary incontinence
may have been due to her reduced ability to mobilize given her leg weakness.
Plasmapheresis. 3/14/08-admitted for

Vaccination Manufacturer Lot Dose Route Site Life Threatening Illness? No
HEPA MERCK & CO. INC. 0250U 1 LA Died? Yes (date died: 2007-06-29)
HPV4 MERCK & CO. INC. 0384U 1 UN LA Disability? No
Recovered? No
Administered by: Other Purchased by: Other ER or Doctor Visit? No
Symptoms: Arrhythmia, Brain death, Brugada syndrome, Convulsion, Death, Hospitalized? Yes, days
Electrocardiogram, Electrocardiogram QT prolonged, Headache, Life support, Rash
Write-up: Information has been received from a consumer concerning her 12 year old
daughter with a history of seizures and heart arrhythmias, who on 25-JAN-2007 was Current Illness:
vaccinated with a first dose of Gardasil. On 27-APRIL-2007 the patient was vaccinated with Diagnostic Lab Data: electrocardiogram
a second dose of Gardasil. Concomitant therapy included LAMICTAL, vitamins Previous Vaccinations:
(unspecified) and KEPPRA. Subsequently, the patient began to have seizures, developed a Other Medications: LAMICTAL; KEPPRA;
rash on her arm, and was complaining about headaches. On 22-JUN-2007 the patient vitamins (unspecified)
experienced a heart arrhythmia and was hospitalized. Due to the arrhythmia the patient was
Preexisting Conditions: Convulsion;
placed on life support and died on 29-JUN-2007. The patient's mother reported that the
Arrhythmia
patient had an electrocardiogram (EKG) about 5 years ago to test for prolonged QT
syndrome. The test came back normal. It was reported that at that time the patient was in and CDC 'Split Type': WAES0804USA00429
out of the emergency room due to having seizures periodically. The patient had been seeing a
neurologist and had not had any seizures for about two years until she received the second
dose of Gardasil. The patient's mother reported after her daughter's death and burial she had
received copies of her daughter's medical records. Throughout the reports it showed that for
the past five years the patient had prolonged QT syndrome, and proguda syndrome "which

causes seizures and heart arrythmias." The patient's cause of death was prolonged QT
syndrome, brain death, and proguda syndrome. No product quality complaint was involved.
The seizures, rash, headaches, heart arrythmias, prolonged QT syndrome, brain death, and
proguda syndrome were considered to be other important medical events. Additional
information is not available.

State: North Carolina Entered: 2008-04-21 Died? Yes (date died: 2008-04-05)
HPV4 MERCK & CO. INC. 1978U UN UN Recovered? No
Hospitalized? No
Symptoms: Autopsy, Biopsy heart abnormal, Biopsy liver abnormal, Biopsy lung abnormal,
Current Illness:
Death, Focal nodular hyperplasia, Hyperplasia, Inflammation, Polymerase chain reaction,
Pulmonary congestion, Toxicologic test normal, Viral test negative Diagnostic Lab Data: autopsy, 04/??/08, ruled
out suicide or anything suspicious; diagnostic
Write-up: Information has been received from a physician concerning a 20 year old female
laboratory, 04/??/08, toxicology results unknown.
with no medical history reported, who on 01-APR-2008 was vaccinated with a dose of
7/16/09 Pathology report received Receipt
Gardasil. On 05-APR-2008, the patient died four days after receiving Gardasil. The patient
02/23/09 Sign-out 07/06/09. Single focus of
sought unspecified medical attention. An autopsy was performed which ruled out suicide and
mononuclear inflammation of th
anything suspicious. The cause of death is currently unknown and they are performing
toxicology tests to try to determine the cause. No product quality complaint was involved. Previous Vaccinations:
The reportable physician considered death to be immediately life-threatening and disabling. Other Medications: Unknown
Additional information has been requested.7/14/08-autopsy report received-COD: Preexisting Conditions: None
Undetermined. Died unexpectedly while working as a health aid. Postmortem examination CDC 'Split Type': WAES0804USA02336
reveals focal nodular hyperplasia in liver; this finding though significant, cannot accoutn for
sudden death. There is no evidence of pregnancy. Toxicology analysis negative. Based on
history, autopys, and toxicological examination, cause of death is undetermined.

Disability? No
State: New Hampshire Entered: 2008-06-23
Recovered? No
HPV4 MERCK & CO. INC. 0928U 0 UN LA Hospitalized? No
Administered by: Private Purchased by: Other Current Illness:
Symptoms: Convulsion, Cyanosis, Death, Mydriasis, Pallor, Pulmonary oedema, Pupil Diagnostic Lab Data:
fixed, Unresponsive to stimuli, Urinary incontinence Previous Vaccinations:
Write-up: Death 9/9/08 Death certificate states COD as idiopathic seizure disorder. 8/5/08 Other Medications:
Reviewed ER medical records of 6/12/2008. Records reveal patient found unresponsive, Preexisting Conditions: Seizures PMH:
prone on her bed when parent went to awake for school. Last seen at bedtime. Pupils fixed & 'problems w/alcohol'.
dilated, cyanotic & pale, incontinent of urine, developed pulmonary edema during CDC 'Split Type':
resuscitation. Unable to resuscitate.

HPV4 MERCK & CO. INC. 0 UN UN Recovered? No
Administered by: Unknown Purchased by: Unknown ER or Doctor Visit? No
Symptoms: Abdominal pain, Death, Haemorrhage, Inappropriate schedule of drug Hospitalized? No
administration Current Illness:
Write-up: Information has been received from a health professional concerning a 42 year Diagnostic Lab Data: Unknown
old female who on 12 Apr 2008 was vaccinated with GARDASIL. Prior to the vaccination, Previous Vaccinations:
the patient was reported looking weak and lost weight. On 14 Apr 2008, the patient returned Other Medications: Unknown
to the clinic and complained of abdominal pain and bleeding. The patient was treated with
painkillers for abdominal pain and advised to return if pain persists. The patient never came Preexisting Conditions: Unknown
back. The second dose was due on 12 Jun 2008 but the patient did not turn up. On 14 Jun CDC 'Split Type': WAES0806MYS00011
2008, the clinic was informed that the patient had died. The cause of death was unknown.
The reporter felt that abdominal pain, bleeding and death were not related to therapy with
GARDASIL. No further information is available.

State: Indiana Entered: 2008-06-27 Died? Yes (date died: 2008-06-15)
Disability? No
Recovered? No
HPV4 MERCK & CO. INC. 1447U 0 UN LA ER or Doctor Visit? No
Administered by: Unknown Purchased by: Unknown Hospitalized? No
Symptoms: Arrhythmia, Cardiomegaly, Cardiomyopathy, Cyanosis, Death, Left ventricular Current Illness: none
hypertrophy, Muscle rigidity, Obesity, Passive smoking, Pulmonary oedema, Splenomegaly, Diagnostic Lab Data: toxicology and other test
Toxicologic test normal, Unresponsive to stimuli came back negative expect trace amount of
Write-up: Death -coroner says enlarged heart & enlarge spleen 7/4/08 Reviewed PCP nicotine (father heavy smoker)
medical records of 1999-6/2008 which included vax record. In 8/2007, c/o of tiredness & Previous Vaccinations:
loss of appetite. Monospot (-). On day of vax, patient was well, weight noted as 237, Other Medications: none
otherwise no complaints. 7/8/08 Autopsy report states COD as arrhythmia due to
cardiomyopathy.States anatomic findings of obesity, pulmonary edema, mild & left Preexisting Conditions: overweight PMH:
ventricular hypertrophy w/myocardial nuclear enlargement. Patient had been found non- recurrent colds/sore throat, neg strep.
responsive by family. EMS found patient cyanotic w/rigor & no further resuscitation was CDC 'Split Type':
performed. Family reported patient had been well earlier in the evening. Albuterol inhaler
was found at scene but no suspicious features at scene.

Age: 20.0 Onset Date: 0000-00-00 Days later: Life Threatening Illness? No
State: Entered: 2008-07-07 Disability? No
Recovered? No
HPV4 MERCK & CO. INC. 0 UN UN
Hospitalized? No
Symptoms: Death, Malaise, Pulmonary embolism Diagnostic Lab Data: Unknown
Write-up: Information has been received from a physician concerning a 20 year old female Previous Vaccinations:
with no relevant medical history reported who was vaccinated with a first dose of Other Medications: Unknown
GARDASIL on an unspecified date. Subsequently, exact onset not reported, the patient felt
unwell. About 6 weeks post vaccination, she experienced pulmonary embolism with fatal Preexisting Conditions: None
outcome. An autopsy is scheduled. Other business partner numbers included: E2008-05832. CDC 'Split Type': WAES0806USA09042

HPV4 MERCK & CO. INC. 1 UN UN Disability? No
Recovered? No
Symptoms: Death, Hypersensitivity
Hospitalized? No
Write-up: Information has been received from a physician who was told by a patient's
mother that a female patient with a sulfa allergy who on an unspecified date was vaccinated Current Illness: Sulfonamide allergy
with a first dose of GARDASIL (lot number, injection site and route not reported), which Diagnostic Lab Data: Unknown
was well tolerated. On an unspecified date, the patient was vaccinated with a second dose of Previous Vaccinations:
GARDASIL (lot number, injection site and route not reported). Subsequently the patient Other Medications: Unknown
died. The cause of death was reported as allergic reaction to GARDASIL. The physician
stated that the patient who died was not her patient and she knew no further details. Follow- Preexisting Conditions:
up information was received from the physician who reported that a other of one of her CDC 'Split Type': WAES0806USA08737
patients had said to her, that she "thought" she read this report on the internet. The physician
asked the patient's mother to find out where she read the report. The patient's mother could
not find the report and did not know where to locate the source information. Additional

State: Maryland Entered: 2008-07-17
Disability? No
HPV4 MERCK & CO. INC. 0053X 2 IM LA ER or Doctor Visit? No
Hospitalized? No
Current Illness: none
Symptoms: Autopsy, Cardiac arrest, Cardiac enzymes normal, Death, Echocardiogram,
Electrocardiogram abnormal, Full blood count normal, Heart rate irregular, Laboratory test Diagnostic Lab Data: none - apparently healthy
normal, Physical examination normal, Pulmonary haemorrhage, Pulmonary oedema, Smear young woman 8/22/08-records received-cardiac
cervix normal, Spleen disorder, Splenomegaly, Supraventricular extrasystoles, Urine alcohol blood neg for ethanol; urine (+) for ethanol=16
test positive mg/dl; liver (+) for acetaldehyde (incidental
finding). 3/5/09-records received-pap smear
Write-up: Pt received her 3rd and final dose of HPV vaccine on 6/3/08. Per mother patient
normal. 2/4/09-records recei
was found dead, in bed on 6/22/08, in her dorm room at an out-of-state college. According to
the autopsy the patient had been dead for about 48 hours. According to mother autopsy was Previous Vaccinations:
negative except for splenic inflammation. 8/22/08 Autopsy report also states Final Other Medications: none
Diagnoses: Cardiac arrest, cause undetermined w/recent history of PAC w/otherwise normal Preexisting Conditions: reported allergy to
EKG; normal echocardiogram 2/08; no evidence of myocarditis; acute pulmonary edema; penicillin and cephid 3/5/09-records received-
slight splenomegaly; cardiac blood neg for ethanol; urine (+) for ethanol=16 mg/dl; liver (+) Allergic to penicillin.
for acetaldehyde (incidental finding). 3/5/09-records received for DOS 8/22/07-seen for CDC 'Split Type':
routine visit and first annual pap test..PE normal. First HPV vaccine administered. 2/4/09-
records received for DOS 11/20/07-C/O chronic PAC and irregular heart beat.

Gender: Female Submitted: 2008-07-18 Life Threatening Illness? Yes
State: Illinois Entered: 2008-07-21 Died? Yes (date died: 2007-09-20)
Vaccination Manufacturer Lot Dose Route Site Disability? Yes
HPV4 MERCK & CO. INC. 0012U 2 UN UN Recovered? No
Hospitalized? No
Symptoms: Cardiac arrest, Convulsion, Death, Fall, Mydriasis, Pulmonary congestion,
Current Illness:
Pulmonary oedema, Pulse absent, Pupil fixed, Respiration abnormal, Syncope, Toxicologic
test normal, Unresponsive to stimuli, Ventricular fibrillation, Visceral congestion Diagnostic Lab Data: Unknown. Labs and
Diagnostics: Tox screen (-).
Write-up: Information has been received from a certified medical assistant concerning a 14
year old female who was vaccinated with a first dose of GARDASIL and experienced Previous Vaccinations:
syncope. She was taken to an emergency room and released. The patient was vaccinated with Other Medications: Unknown
a second dose of GARDASIL (unspecified time). Subsequently, the patient experienced her Preexisting Conditions: Unknown. PMH: 1
first seizure (unspecified time) and was taken to the emergency room (no further details prior seizure 8/2007. 4/28/09 Additional records
provided). The patient was vaccinated with a third dose of GARDASIL at 15 years old. received from PCP at CDC's request. Pt in for
Approximately 27-JUN-2008, two weeks after the third dose, the patient developed a OV 1/30/07 with c/o allergy sx and requesting
complication. She was taken to the hospital by ambulance but passed away during the HPV#1-given 0012U. Returned 3/22/07 for
transport from an unknown cause. The physician has asked the mother for the autopsy report. HPV#2-given 1427F with Boostrix
The reporting medical assistant considered the syncope, seizure and "a complication" were AC52B012AA. Mild URI 4/25/07. OV 6/12/07
considered to be immediately life-threatening and disabling. Additional information has been in F/U to ER visit for seizure on 6/11/07.
requested. 2/13/09 Autopsy report received. COD: Seizure Disorder. Summary Diagnoses: Syncope noted. Sent for tests. OV 6/28/07 Echo
Clinical history of seizure disorder. Pulmonary congestion and edema. Passive visceral and blood work repor
congestion. 2/20/2009 ER received from CDC. Pt presented to ER via EMS following CDC 'Split Type': WAES0807USA02139
witnessed seizure activity with fall from standing. Upon EMS arrival pt had agonal
respirations and was pulseless in V-fib at 650. Upon arrival in ER unresponsive, pupils fixed
and dilated, no cardiac activity. Resuscitation unsuccessful and pt expired.

Disability? No
Recovered? No
Write-up: Initial and follow up information has been received from a physician, who was Previous Vaccinations:
told by one of his patients, that the mother of a consumer was told by a neurologist that there Other Medications: Unknown
were 4,400 kids who have died following vaccination with GARDASIL. No product quality Preexisting Conditions: Unknown
complaint was involved. Attempts are being made to verify the existence of patients. CDC 'Split Type': WAES0806USA08705

Age: 21.0 Onset Date: 0000-00-00 Days later:
HPV4 MERCK & CO. INC. 2 UN UN Disability? Yes
Recovered? No
Symptoms: Death, Fatigue, Injection site pain, Viral infection
Hospitalized? No
who on an unspecified date was vaccinated with her third dose of GARDASIL. Subsequently Current Illness:
the patient experienced soreness at the injection site and fatigue. The outcome of soreness at Diagnostic Lab Data: Unknown
the injection site and fatigue was not reported. Two months after receiving her third dose of Previous Vaccinations:
GARDASIL, the patient died. The cause of death was "viral insult to the heart". Unspecified Other Medications: Unknown
medical attention was sought. Follow-up information was received via telephone call from
the physician. The patient was a family member. She did not have the vaccination dates or Preexisting Conditions: Unknown
lot numbers since she did not give them. The physician reported that the patient's mother CDC 'Split Type': WAES0807USA04740
thought that the patient died related to GARDASIL. She did not have the cause of death. The
physician refused to provide patient information, information was gave to the coroner. The
physician considered "viral insult to the heart" to be immediately life-threatening and
disabling. Additional information has been requested.

HPV4 MERCK & CO. INC. 2 UN UN Disability? Yes
Recovered? No
Symptoms: Death, Fatigue, Injection site pain, Viral infection
Hospitalized? No
who on an unspecified date was vaccinated with her third dose of GARDASIL. Subsequently Current Illness:
the patient experienced soreness at the injection site and fatigue. The outcome of soreness at Diagnostic Lab Data: Unknown
the injection site and fatigue was not reported. Two months after receiving her third dose of Previous Vaccinations:
GARDASIL, the patient died. The cause of death was "viral insult to the heart". Unspecified Other Medications: Unknown
medical attention was sought. Follow-up information was received via telephone call from
the physician. The patient was a family member. She did not have the vaccination dates or Preexisting Conditions: Unknown
lot numbers since she did not give them. The physician reported that the patient's mother CDC 'Split Type': WAES0807USA04740
thought that the patient died related to GARDASIL. She did not have the cause of death. The
physician refused to provide patient information, information was gave to the coroner. The
physician considered "viral insult to the heart" to be immediately life-threatening and
disabling. Additional information has been requested.

Disability? No
HPV4 MERCK & CO. INC. UN UN ER or Doctor Visit? No
Hospitalized? No
Current Illness:
Symptoms: Death
Write-up: Information has been received from a physician concerning his patient's daughter
who on an unspecified date was vaccinated with a dose of GARDASIL. The patient's mother Previous Vaccinations:
told to the physician that her daughter died in her dorm room 4 days after receiving the dose. Other Medications: Unknown
The physician did not have much information because he did not administer the vaccine and Preexisting Conditions: Unknown
the patient's daughter was not his patient. The reporter did not know the name of the CDC 'Split Type': WAES0807USA04504
physician who administered the vaccine. The physician considered the event to be life
threatening. Additional information has been requested.

State: Missouri Entered: 2008-08-08
HPV4 MERCK & CO. INC. 1487U 1 IM LA Life Threatening Illness? No
Administered by: Private Purchased by: Private
Disability? No
Symptoms: Arrhythmia, Brain oedema, Cardiac arrest, Computerised tomogram,
Convulsion, Cough, Death, Dyspnoea, Fall, Haemorrhage, Headache, Hypotonia, Laboratory Recovered? No
test, Lobar pneumonia, Loss of consciousness, Organ donor, Respiratory tract congestion, ER or Doctor Visit? No
Syncope, Tongue biting, Tremor, Upper respiratory tract congestion, X-ray Hospitalized? Yes, 5 days
Write-up: To Whom It May Concern: My daughter went to our nurse practitioner at Health Extended hospital stay? No
Care Center on March 31, 2008 for a sore throat. She complained of her throat for about two Current Illness: Sore throat
days prior. Pt would get pharyngitis and strep about twice a year since she was 13. She
Diagnostic Lab Data: lab work, Cat scans, X-
received a shot of ROCEPHIN in the office on March 31st as well she was given a
rays
prescription for ZITHROMAX (Z-PAK) at the same time. I'm not sure exactly what time her
appointment was it was around 11:00 am. that day. She dropped off her prescription at the Previous Vaccinations:
pharmacy and I picked up on my way home. She took her first dose of ZITHROMAX on the Other Medications: 3/31 ROCEPHIN; 3/31
31st. She stayed home from school the next two days. She slept late both days which is not ZITHROMAX
abnormal for her. In the evenings we played rummy, she was congested and coughing a little. Preexisting Conditions: Hx of pharyngitis;
She complained of a headache the next night and I gave her some ibuprofen. On Wednesday Bacterial Meningitis at 17 mons
April 3rd she went to school, (school gets out at 3:05 p.m.) after school she went to tract CDC 'Split Type':
practice. Her tract practice was a short one, I know she ran but I'm not sure how much. She
stopped at a convenience store on the way home from school and got a Red Bull. She went
home and changed clothes for work. She called me between 4:30 and 5:00 p.m. on her way
to work to tell me about the road being blocked due to rain where we live. She parked her car
and was walking the short distance into where she works she collapsed and started seizing. A
lady in the drive through told the owner that she had fallen and he went out immediately. He
said she was shaking, the employees inside called 911 and then me. The owner told me she

stopped shaking and took a few strained breaths and then went limp. The police officer arrive
within three minutes, he was a first responder. He did not check for a pulse or attempt CPR (I
am in the process of getting a police report as well). Just as I got there an off duty paramedic
arrived and started CPR. It took quite awhile before the ambulance arrived; she had been
down too long. I later learned that they did not get her heart started unt

State: Unknown Entered: 2008-08-15 Recovered? No
HPV4 MERCK & CO. INC. 2 UN UN Hospitalized? No
Current Illness:
Symptoms: Death Previous Vaccinations:
Write-up: Information has been received from a registered nurse (R.N.) concerning a 22 Other Medications:
year old female (a relative of another employee) who was vaccinated with a third dose of
GARDASIL. Subsequently the patient died. The cause of death was unknown. Additional Preexisting Conditions: Unknown
information has been requested. CDC 'Split Type': WAES0808USA01968

State: Utah Entered: 2008-08-27 Disability? No
HEPA SMITHKLINE BEECHAM AHAVB143AA 0 IM RA
HPV4 MERCK & CO. INC. 0522U 0 IM RA
TDAP UNKNOWN MANUFACTURER C2734AA 0 IM LA
Current Illness:
Administered by: Other Purchased by: Other Diagnostic Lab Data: None LABS: EMG/NCS
Symptoms: Activities of daily living impaired, Amyotrophic lateral sclerosis, Antinuclear abnormal. Brain MRI abnormal; c-spine MRI
antibody positive, Asthenia, Ataxia, Axonal neuropathy, Biopsy muscle abnormal, Blood WNL. CSF WNL. West Nile IgG (+), IgM (-)but
immunoglobulin G increased, Blood immunoglobulin M, Blood product transfusion, CSF testing done s/p IVIG. ANA (+). Echocardiogram
culture negative, CSF glucose normal, CSF oligoclonal band absent, CSF protein normal, WNL, SPI-C MRI. Muscle biopsy (+) marked
CSF test normal, Chest X-ray abnormal, Computerised tomogram normal, Constipation, neurogenic changes. CXR (+) for possibl
Cough, Dehydration, Depression, Dysarthria, Dysphagia, Dysphonia, Dyspnoea, Dysstasia, Previous Vaccinations:
Echocardiogram normal, Electrocardiogram ST segment depression, Electrocardiogram Other Medications: therapy unspecified
abnormal, Electromyogram abnormal, Facial paresis, Fatigue, Gastrointestinal tube insertion,
Preexisting Conditions: None 11/28/2007 -
Guillain-Barre syndrome, Headache, Intensive care, Motor dysfunction, Motor neurone
Received Twinrix, IM, RA, lot# AHABB100AA
disease, Muscle contractions involuntary, Muscular weakness, Musculoskeletal pain, Nausea,
PMH: purpura fulminans age 5 or 8 s/p
Neck pain, Nerve conduction studies abnormal, Nervous system disorder, Neurological
chickenpox. Pulmonary HTN in childhood.
examination abnormal, Neuromyopathy, Nuclear magnetic resonance imaging brain
Underweight at birth & Nissen surgery w/G-tube
abnormal, Oral intake reduced, Pneumonia aspiration, Progressive bulbar palsy, Pulmonary
as newborn for 1st year of life, repair of pectus
function test abnormal, Red blood cell sedimentation rate normal, Red blood cells CSF
excavatum age 17. Oral contraceptives,
positive, Respiratory failure, Tachycardia, Virus serology test positive
hypothyroidism. Allergic sulfa. Family hx of
Write-up: Information has been received from a neurologist concerning a 21 year old female seizures
previously in good health who in March 2008, was vaccinated with the first dose of
CDC 'Split Type': WAES0808USA03969
GARDASIL (lot# not provided). Concomitant medication included several other
vaccinations (not including MENACTRA). Subsequently, the patient developed motor

neuron disease consistent with amyotrophic lateral sclerosis (ALS). Her progressive clinical
course began in April 2008. The patient had not received a second dose of GARDASIL or
any other vaccines since onset of symptoms. She developed upper extremity weakness which
had become generalized and much more severe. She had been hospitalized in intensive care
for several weeks with respiratory failure. Her condition deteriorated despite treatment with
immunoglobulin. She had upper and lower motor neuron features with fasciculations. There
is no sensory loss. Diagnostic workup included cerebrospinal fluid analysis (CSF) and
muscle biopsy that ruled out other conditions (such as Guillaine Barre) and clinical picture is
consistent with amyotrophic lateral sclerosis. Antineuronal antibodies were pending. A
Superoxide dismutase (SOD) was pending and Stathmin (SMN) test will be ordered if SOD
was normal. The reporting physician did not believe that illness was related to GARDASIL.
Additional information has been requested. This is one of several reports from the same
source. 9/9/08 Autopsy states COD as unclassified neurologic process, clinically presumed to
be atypical GBS vs bulbar varient of ALS. FINAL DX 8/17-8/21/08 admission: amyotrophic
lateral sclerosis & death by respiratory collapse. Developed cough, difficulty breathing,
difficulty swallowing, poor oral intake, constipation, lack of energy 6 days prior to admit;
had received Depo-Provera & outpatient IVIG prior to admit w/o any improvement.
Admitted to ICU. Gradually worsened over the hospital stay, had NGT for feeding but
refused PEG tube placement or tracheostomy. Referred to hospice & expired. FINAL DX
7/28-8/1/2008 admission: axona

State: Ohio Entered: 2008-09-03 Recovered? No
Hospitalized? No
Current Illness: none noted
Diagnostic Lab Data: Full Autopsy done.
Immediate cause of death was massive
Administered by: Unknown Purchased by: Unknown pulmonary embolus. Secondary was Type 1
Symptoms: Autopsy, Circulatory collapse, Dehydration, Diabetic ketoacidosis, Laboratory Diabetes (previously undiagnosed). Vitreous
test abnormal, Pulmonary embolism, Sudden death Humor glucose was 767 9/4/08-records received-
Vitreous glucose 767.
Write-up: Sudden death occured on 3/12/2008. 9/4/08-records received-Cause of
Death:cardiovascular collapse as a consequence of pulmonary emboli, dehydration and Previous Vaccinations:
diabetic ketacidosis. Other Medications: none
Preexisting Conditions: none
CDC 'Split Type':

State: Kansas Entered: 2008-09-15
HPV4 MERCK & CO. INC. 1740U 0 UN UN Died? Yes (date died: 2008-08-04)
Administered by: Other Purchased by: Other Disability? No
Symptoms: Abdominal pain, Alanine aminotransferase increased, Antinuclear antibody Recovered? No
negative, Aspartate aminotransferase increased, Asthenia, Azotaemia, Blood bicarbonate ER or Doctor Visit? Yes
decreased, Blood creatine phosphokinase increased, Blood creatinine increased, Blood Hospitalized? Yes, 2 days
culture negative, Blood potassium decreased, Blood sodium decreased, Blood thyroid Extended hospital stay? Yes
stimulating hormone decreased, Blood urea increased, Brain natriuretic peptide increased, C-
Current Illness: Acne
reactive protein increased, Cardiac enzymes increased, Cardiac failure congestive,
Cardiomyopathy, Catheterisation cardiac abnormal, Chest X-ray abnormal, Chest pain, Diagnostic Lab Data: Unknown LABS: WBC
Chills, Death, Dizziness, Drug screen negative, Dyspnoea, Ejection fraction decreased, 10.3(H). Troponin greater than 100(H) & CPK
Electrocardiogram ST segment elevation, Electrocardiogram abnormal, Hypotension, 5492(H), CKMB 313.1(H) c/w infectious
Hypoxia, Intensive care, Intra-aortic balloon placement, Malaise, Methicillin-resistant myocarditis, possibly viral. TSH 0.09(L). CRP
staphylococcal aureus test negative, Myocardial infarction, Myocarditis infectious, Pain, 38.3(H). BNP 533(H). ANA neg. ASO 200(+).
Pyrexia, Respiratory distress, Shock, Streptococcal identification test positive, Tachycardia, CXR abnormal w/water bottle appearing hea
Troponin increased, Ventricular tachycardia, Viral cardiomyopathy, Viral myocarditis, Previous Vaccinations:
White blood cell count increased Other Medications: erythromycin
Write-up: Information has been received from a physician concerning a 17 year old female Preexisting Conditions:
with acne who on 24-JUL-2008 was vaccinated with the first dose of GARDASIL. CDC 'Split Type': WAES0809USA00837
Concomitant therapy included erythromycin, solution, topical. On 04-AUG-2008, the patient
experienced abdominal pain, chest pain and aching everywhere and was hospitalized. On 05-
AUG-2008, the patient experienced myocarditis and died. Diagnosis was myocarditis but the
doctor said it was not related to GARDASIL. The last time she was seen in this office was
2005. No additional information at this time. Additional information has been requested.
10/01/08 Death certificate states COD as myocarditis & CHF as contributing factor. 9/22/08

Reviewed PCP medical records. Reveals patient experienced abdominal pain, chest pain &
aching everywhere. Expired 8/5/08 w/viral infection of the heart. Concomitant med was
erythomycin topical solution for acne. Patient noted to be in good health on day of
vaccination. 4/2/09 Received hospital medical records for 8/3-8/4/2008. FINAL DX:
deceased secondary to severe nonischemic cardiomyopathy secondary to viral myocarditis
Records reveal patient experienced fever, chills, feeling unwell x 2-4 days. Presented to ER
w/abdominal & chest pain, weakness, dizziness, hypotensive, tachycardia, SOB, respiratory
distress w/hypoxemia, azotemia, shocklike symptoms. EKG w/diffuse ST changes & ST
elevations. Dx w/acute anteroseptal MI Emergent cardiac cath revealed EF 23% & balloon
pump placed. Intensive care, deteriorated, V-tach, decompensation, extensive resuscitation
efforts failed.

Gender: Female Submitted: 2008-09-02 Disability? Yes
State: Utah Entered: 2008-09-16 Recovered? No
HEPA GLAXOSMITHKLINE BIOLOGICALS AHAVB143AA 0 IM RA
Extended hospital stay? Yes
Current Illness: None
TDAP SANOFI PASTEUR C2734AA 0 IM LA
Administered by: Public Purchased by: Private Previous Vaccinations:
Symptoms: Death, Dyspnoea, Muscular weakness Other Medications: LEVOXYL .88 mcg; Birth
Write-up: April 2008, started experiencing symptoms of muscle weakness in arms and neck, Control
they progressed to interfering with muscle weakness in throat and breathing. Patient died on Preexisting Conditions: Hypothyroid
August 21, 2008. CDC 'Split Type':

State: Illinois Entered: 2008-12-10 Died? Yes (date died: 2008-12-08)
Disability? No
Recovered? No
FLUN MEDIMMUNE VACCINES, INC. 500569P
HPV4 MERCK & CO. INC. 0070X 2 LA
Hospitalized? No
MNQ SANOFI PASTEUR U2730AA RA Current Illness: None.
Administered by: Unknown Purchased by: Unknown Diagnostic Lab Data: Autopsy performed 12-9-
Symptoms: Autopsy, Cold sweat, Death, Dizziness, Headache, Malaise, Nausea, 08 was unrevealing per family verbal report to
Toxicologic test normal, Urinary incontinence me; no signs of intracranial bleed, meningitis,
cardiomyopathy, trauma. Toxicology report still
Write-up: Patient, a previously healthy 19 year-old female college freshman died suddenly
pending at this time. Post-mortem tox screen (-).
yesterday, approximately 10 days after receiving Gardasil & menningococcal vaccines.
Vaccines were administered by a medical provider in her hometown while she was home for Previous Vaccinations:
the Thanksgiving holiday, sometime around 11-28-08. She had a medical appointment Other Medications: None known. ?? oral
pending for 12-8-08 (the day of her death) with the Student Health Service; medical clerk contraceptive or an antibiotic for acne.
had entered "possible seizure" as the reason for making the appointment. Patient had no Preexisting Conditions: Acne. PMH: PCN
history of epilepsy. She complained of a headache and not feeling well in the 24 hours prior allergy. Acne. On OCs (Yaz). 12/10/2008
to her death. She went to bed at 10:30 PM on 12-7-08, in her dorm room with a roomate. She Recived records from health center via CDC.
appeared to still be sleeping the next morning when her roomate left for class. Her body was Seen 11/3/08 with c/o sore throat, cough, muscle
discovered still in bed around 5 PM that day (12-8-08) with rigor mortis. No history of aches and nasal d/c. PE (+) for pharyngeal
substance abuse, alcohol intake, or depression or other mental health issues. She was a erythema, purulent nasal drainage, nasal turbinate
happy, achieving student. This report is filed by a friend of patient's parents, who is a changes, and lymphadenopathy. Assessment:
physician (board certified internal medicine & geriatrics). Report also filed online today with Probable viral URI with ? sinusitis. Tx: Biaxin.
the FDA. Patient's mother can be reached at home for additional details. Memorial service &
CDC 'Split Type':
funeral 12-12-08 and 12-13-08. Only known past medical history requiring physician
attention was facial acne. 12/10/2008 Recived records from health center via CDC. Seen
11/3/08 with c/o sore throat, cough, muscle aches and nasal d/c. PE (+) for pharyngeal

erythema, purulent nasal drainage, nasal turbinate changes, and lymphadenopathy.
Assessment: Probable viral URI with ? sinusitis. Tx: Biaxin. Received from CDC via email:
The patient had no previous health problems. She was a freshman and was seen at the college
health clinic only once on 11/3/08 for sinusitis. She was on Yaz birth control pills and a
topical acne medication. After the death, police questioned her roommate who said that the
pt did go out on the evening of 12/6/08 and had a few alcoholic drinks, but not an excessive a

HPV4 MERCK & CO. INC. 1 IM UN Died? Yes (date died: 0000-00-00)
Disability? No
Recovered? No
Symptoms: Autopsy, Death, Headache, No reaction on previous exposure to drug, Pain,
Ruptured cerebral aneurysm
Hospitalized? No
Write-up: Information has been received from a general practitioner concerning an 18 year
old female with pollen allergy, allergic asthma and who was overweight, with a family Current Illness: Pollen allergy; Allergic asthma;
history of the mother having multiple sclerosis, who on 12-MAR-2008 was vaccinated with Overweight
the first dose of GARDASIL, lot # not reported, which was well tolerated. It was reported Diagnostic Lab Data: Unknown
that the second dose of GARDASIL, lot # not reported, was given intramuscularly (IM) to Previous Vaccinations:
the right deltoid on 21-APR-2008. Concomitant therapy included SERETIDE, albuterol, Other Medications: KESTINE; NASACORT;
NASACORT and KESTINE. There was no contraceptive use. On 16-JUL-2008 the patient SERETIDE; albuterol
experienced sudden brutal cephalgia and then she suffered from a pain evocating an
aneurysm during rupture. The patient suddenly died in spite of resuscitation technique Preexisting Conditions:
performed by the agency which evoked a ruptured aneurysm. An autopsy was on-going and CDC 'Split Type': WAES0812USA02421
the results would be provided. As to the reporter there may not be any link between adverse
effect and vaccination. The reported cause of death by the ageny was ruptured cerebral
aneurysm, but it had not been confirmed yet by the results of the autopsy which were still
pending. Additional information has been requested. Other business partner numbers include
E2008-11575.

State: New Mexico Entered: 2009-01-14 Recovered? No
Hospitalized? No
HPV4 MERCK & CO. INC. 1060U 1 UN RA
Current Illness:
Administered by: Unknown Purchased by: Unknown Diagnostic Lab Data: 1/29/09-records received-
Symptoms: Autopsy, Contraception, Death, Smear cervix normal COD-undetermined. krk 6/23/09-pathology
report received: autopsy tissues without evidence
Write-up: My daughter had her 3rd GARDASIL vaccine in Sept. She was a very healthy
of an infectious process. 6/26/09 Medical records
young lady, she went to take a shower and died. Autopsy report states undermined death.
received DOS 10/29/07 to 1/14/08. LABS and
There was no sign of trauma to the body to indicate a fall. She had pointed the shower head
DIAGNOSTICS: PAP Tests (-).
away from her and she got down on her knees and put her head on the edge of the tub and
passed away. This has been a living nightmare for her family. She is not the only one to have Previous Vaccinations:
had problems and death from this vaccine. Please I beg you to please take it off until it can Other Medications:
be further tested. -not tested long enough to begin with- There will be others that will die if Preexisting Conditions: No medical problems--
the cause is not found. 1/29/09-records received-COD-undetermined. 6/26/09 Medical no allergies -- No drug use, alcohol or smoking.
records received DOS 10/29/07 to 1/14/08. Assessment: Immunizations and Contraceptive Had all her medical check ups!!!
Management. HPV#1 10/29/07 LA Merck Lot# 1062U CDC 'Split Type':

State: New Mexico Entered: 2009-01-21 Recovered? No
Hospitalized? No
HPV4 MERCK & CO. INC. 0955f 0 IM LA
Current Illness: Went in for sinisitus, and had a
sore throat. She had bad sinus allergies. But they
Administered by: Unknown Purchased by: Unknown still gave her the shots.
Symptoms: Abnormal behaviour, Autopsy, Cell death, Clostridium difficile toxin test Diagnostic Lab Data: 4/7/09-path report
positive, Death, Dermatitis contact, Fatigue, Headache, Hypersomnia, Menorrhagia, received-multiple tissues with extensive autolysis
Menstrual disorder, Metrorrhagia, Muscle spasms, Nasal congestion, Oropharyngeal pain and bacterial overgrowth. Molecular evidence of
a Clostridium sp.
Write-up: Headaches, periods were very erratic. She would have them every 14 days
@times, and others just spotting. Very bad cramps and periods were heavier after the 1st Previous Vaccinations: none~
Gardasil shot. Wasn't her normal spunky and happy self. She was very tired and the last few ()~~0~Patient|none~ ()~~0~Sibling
weeks before she passed away, sheslept alot during the day which she never did. Never had Other Medications: Nasonex (Pseudovent 400
any other problems prior to the Gardasil shots. She recieved all three shots in the series. Last substituted for Entex 400 120 capsule),Claritan,
shot was 5-2-2007. 2/9/09-autopsy report received-COD-undetermined by autospy and Triamcinolene Acetonide cream for rash on
toxicology.3/18/09-records received-well visit C/O contact dermatitis, nasal congestion, wrist.
itchy sore throat times 2-3days. HPV4 lot#1424 F received 1/3/07 in right deltoid. Lot Preexisting Conditions: Seasonal allergies.
#0384U received 5/2/07 left deltoid and 12/2/08 lot#0955F left deltoid. None other.
CDC 'Split Type':

HPV4 MERCK & CO. INC. 1316U 1 IM LA Recovered? No
Symptoms: Autopsy, Death Hospitalized? No
Write-up: Information has been received from a health authority (reference # Current Illness:
PEI2009000661) concerning a 15 year old female who on 20-OCT-2008 was vaccinated Diagnostic Lab Data: Unknown
with the first dose of GARDASIL, lot #1427U (batch #NH15200) IM into the left upper arm. Previous Vaccinations:
No information regarding toleration was given. On 29-DEC-2008, the patient was vaccinated Other Medications:
with a second dose of GARDASIL, lot #1316U (batch #NH45640) IM into the left upper
arm. On 30-DEC-2008 the patient died. According to the preliminary report, the autopsy Preexisting Conditions: Unknown
showed no acute or chronic organic disease. The possibility of carbon monoxide intoxication CDC 'Split Type': WAES0901USA03040
was not yet ruled out. Investigation by public prosecution is ongoing. Lot checks have been
requested. Other business partner numbers included: E2009-00404. Additional information
has been requested.

State: Entered: 2009-01-29 Life Threatening Illness? No
Disability? No
Recovered? No
Symptoms: Arrhythmia, Atrial fibrillation, Autopsy, Blood glucose increased, Body Hospitalized? Yes, 0 days
temperature decreased, Body temperature increased, Cyanosis, Death, Drug screen negative, Extended hospital stay? No
Dyspnoea, Electrocardiogram abnormal, Hyperthermia, Hypothermia, Intensive care,
Current Illness: Asthenia; Anxiety; Overwork;
Laboratory test normal, Leukocytosis, Lung disorder, Malaise, Multi-organ failure,
Psychological disorder NOS
Mydriasis, Tachycardia, Tremor, Ventricular hypokinesia, White blood cell count increased,
X-ray abnormal Diagnostic Lab Data: electrocardiogram,
03Jan09, arrhythmia with atrial fibrillation; X-
Write-up: Information has been received from a specialist and from the health authority,
ray, 03Jan09, pneumopathy of right middle
concerning a 20 year old female with asthenia, anxiety/overwork syndrome and psychologic
pulmonary lobe and septal hypokinesia; body
fragility since May 2008 and a history of cardiac murmur during childhood, who in OCT-
temp, 01?Jan09, 38 C; WBC count, 03Jan09,
2008 was vaccinated with the first dose of GARDASIL. The patient had no adverse effects
12.4.103/mm3; body temp, 03Jan09, 33.7 C; blo
after this dose. Concomitant therapy included BUSPAR, LEXOMIL, magnesium
(unspecified) (+) pyridoxine hydrochloride and hormonal contraceptives (unspecified). On Previous Vaccinations:
27-DEC-2008 the patient was vaccinated with the second dose of GARDASIL, batch number Other Medications: BUSPAR; LEXOMIL;
not reported. It was reported that 3 days after the second dose of GARDASIL, i.e. in JAN- hormonal contraceptives (unspecified);
2009 the patient presented with hyperthermia at 38 C associated with breathlessness. After a magnesium (unspecified) (+) pyridoxine
malaise during shopping on 01-JAN-2009 the patient consulted her general practitioner; she hydrochloride
had tremor and tachycardia. Blood analysis was performed on 03-JAN-2009 and revealed a Preexisting Conditions: Cardiac Murmur
slight hyperleukocytosis (12.4 103/mm3). By the evening on 03-JAN-2009 the patient CDC 'Split Type': WAES0901USA03398
presented with a malaise again but with no dyspnea and after taking BUSPAR. 2 hours later
the intervention of EMUR (emergency medical mobile unit) could lead to recuperate a
sinusal rhythm. Continuous arrhythmia with atrial fibrillation was diagnosed. The patient
was transferred to medical intensive care service: she presented with bilateral mydriasis,

hypothermia at 33.7 C, the result of measure of sugar in her blood was increased at 3.18 and
she had cyanosis of face, ears, and extremities. Radiological examinations revealed a
pneumopathy of the right middle pulmonary lobe and septal hypokinesia with paradoxical
septal. There was no cocaine and no benzodiazepines. The patient presented with multiorgan
failure under high dose of amines and then she dies in spite of the cardiopulmonary by-pass
and extra corporeal oxygenation assistance. An autopsy was performed (unspecified date)
and found no cause of death, also reported as information on autopsy was still awaited. Other
business partner numbers incl

State: Illinois Entered: 2009-02-18 Recovered? No
Hospitalized? No
HPV4 MERCK & CO. INC. 1978U 2 UN UN
Current Illness:
Diagnostic Lab Data: 3/9/09-records received-
WBC 17.3.
Previous Vaccinations: Bloodclot~HPV
Administered by: Private Purchased by: Private (Gardasil)~3~13~Patient
Symptoms: Cardiac arrest, Cardiomegaly, Cough, Pulmonary embolism, Upper respiratory Other Medications:
tract congestion, White blood cell count increased Preexisting Conditions: 5/7/09-records
Write-up: She developed a pulmonary embolism after having 3 rounds of vaccine received-5/7/09-records received-office visit
GARDASIL. She was a healthy, active teenager. 2/23/09-autopsy report received immediate 4/21/00-evaluation for dehydration, vomiting,
cause:Massive pulmonary embolism. Mild cardiomegaly. Last several days C/O cough and sore throat and febrile. Impression strep
congestion. 3/9/09-ED records received for DOS 10/26/08-presented in full cardiac arrest pharyngitis. 9/2/05-routine physical.
after suffering a full and prolonged cardiac arrest, aystole. Expired. Assessment:overweight. Office visit 1/4/08-C/O
lump in neck noticed in 9/07. Intermittently
hurts. Assessment:mild lymphadenopathy.
CDC 'Split Type':

State: Entered: 2009-03-04 Recovered? No
Hospitalized? No
Current Illness:
Administered by: Unknown Purchased by: Unknown Diagnostic Lab Data: Unknown
Write-up: Information has been received from an Agency concerning a 14 year old female Other Medications: Unknown
who was vaccinated with GARDASIL, lot # not available. Subsequently the patient died. Preexisting Conditions: Unknown
The cause of death was unknown. Additional information has been requested. CDC 'Split Type': WAES0902CAN00119

HPV4 MERCK & CO. INC. UN UN Recovered? No
Symptoms: Autopsy, Hypertrophic cardiomyopathy, Sudden death Hospitalized? No
Write-up: Information has been received from a physician, via agency, as part of a business Current Illness: Contraception
agreement (manufacturer control No. GARD 2009 03 27 LS2), concerning a 23 year old Diagnostic Lab Data: Unknown
female who in November 2008 was vaccinated with GARDASIL. Concomitant therapy Previous Vaccinations:
included hormonal contraceptives (unspecified) in the form of a vaginal contraceptive ring. Other Medications: hormonal contraceptives
On 26-NOV-2008, a few days after vaccination with GARDASIL the patient died suddenly. (unspecified)
The cause of death was attributed to hypertrophic cardiomyopathy. It was reported that an
autopsy was performed (report not provided). A few days prior to her death, the patient had Preexisting Conditions:
visited her physician to discuss contraception. She was not taking any other drugs other than CDC 'Split Type': WAES0903AUS00084
contraception and had no underlying conditions or hereditary conditions. The reporter
considered that hypertrophic cardiomyopathy was not related to therapy with GARDASIL,
stating "I'm sure it was not directly related". Additional information has been requested.

Gender: Submitted: 2009-04-08 Disability? No
State: Virginia Entered: 2009-04-09 Recovered? No
Hospitalized? No
Current Illness:
Write-up: Information has been received from a physician concerning an 11 year old patient Other Medications: Unknown
who was vaccinated with GARDASIL (lot number, route and site not reported). Preexisting Conditions: Unknown
Subsequently the patient died. Additional information has been requested. CDC 'Split Type': WAES0904USA00201

State: Georga Entered: 2009-04-15 Life Threatening Illness? No
HEPA SMITHKLINE BEECHAM AHAVB262A 0 UN UN Disability? No
HPV4 MERCK & CO. INC. 0570X 0 UN UN Recovered? No
MNQ SANOFI PASTEUR U2670AA 0 UN UN ER or Doctor Visit? Yes
Hospitalized? No
TDAP GLAXOSMITHKLINE BIOLOGICALS AC52B029AA 0 IM LA
Current Illness: sore throat 4/24/09 PCP records
Administered by: Other Purchased by: Other received which reveal 11yr WCC 3/31/09 with
Symptoms: Abasia, Abnormal behaviour, Alanine aminotransferase increased, Aldolase no medical c/o. Vax given- Hep A, Gardasil,
increased, Anion gap increased, Arthralgia, Aspartate aminotransferase increased, Bacterial TDaP a
infection, Band neutrophil percentage increased, Blood albumin decreased, Blood chloride Diagnostic Lab Data: diagnostic laboratory, a
decreased, Blood creatine phosphokinase normal, Blood glucose increased, Blood lactate group A strep in the blood was found. Labs
dehydrogenase increased, Blood potassium decreased, Blood sodium decreased, Blood test 4/1/09: CBC with WBCs 11.1 73% segs, 13.1%
abnormal, Carbon dioxide decreased, Chest X-ray abnormal, Culture urine positive, Death, lymphs, 12.6% monos. UA WNL Labs 4/3/09:
Endotracheal intubation, Full blood count, Globulins increased, Glucose urine, Haematocrit CK 116. LDH 389. Na+ 131. K 3.1. Cl 94. CO2
normal, Haemodynamic instability, Haemoglobin normal, Hypotension, Immunisation 18.6. Anion gap 21.5. Glucose 170. Albu
reaction, Infective myositis, Lymphocyte percentage decreased, Mean cell haemoglobin Previous Vaccinations:
decreased, Mean cell volume decreased, Monocyte percentage increased, Myalgia, Nausea,
Necrotising fasciitis, Neutrophil percentage increased, Oedema peripheral, Pain, Pain in Other Medications:
extremity, Pyrexia, Rash, Red blood cell abnormality, Resuscitation, Septic shock, Sleep Preexisting Conditions: PMH: foot swelling.
disorder, Streptococcal bacteraemia, Streptococcal identification test positive, Tenderness, Sickle-cell trait.
Urine analysis normal, Urobilin urine present, Viral infection, Vomiting, White blood cell CDC 'Split Type': WAES0904USA01011
count increased
Write-up: Information has been received from a physician concerning an 11 year old female
who on 30-MAR-2009 (last week) was vaccinated with the first dose of GARDASIL.
Concomitant therapy included VAQTA, MENACTRA and DTAP (unspecified) on the same

day. Patient complained about sore throat a week prior to vaccination. A week later some
kind test was performed and it showed that a group A strep in the blood was found. On
approximately 30-MAR-2009, after getting the first dose of GARDASIL the patient
experienced fever and pain in the hip after getting the vaccine. The patient died on 03-APR-
2009. The patient sought unspecified medical attention. Additional information has been
requested. 4/24/09 ER record received for DOS 4/1/09 with dx: Fever. Pediatric Viral
syndrome. Pt presented with L hip pain and fever. PE (+) for tenderness over L anterior
thigh. Tx with analgesic and d/c. 4/24/09 ER record received for DOS 4/3/09 with dx: Post-
vaccination reaction. Pt presented again to ER with fever of 102'F, body aches, inability to
walk 2' to leg pain, nausea, vomiting, rash and polymyagias. PE (+) for extremity pain and
swelling, rash, as well as not sleeping and acting differently. Transferred to higher level of
care. 4/24/09 MR received for DOS 4/3-4/2009 with Final DX: Necrotizing fasciitis (gram
(+) cocci with septic shock). Pt expired 4/4/09. Pt admitted from local facility for eval of
fever with difficulty ambulating. Neuro/ortho consults on arrival with probable dx: infectious
myositis. Tx with IV abx however IV access was lost and pt became hypotensive and with
eveidence of septic shock with cardiovascular instability. Pt intubated and despite extensive
resuscitation efforts pt expired. 4/24/09 Autopsy report received with COD: Necrotizing
Fasciitis (Gram (+)) with septic shock.

Disability? Yes
State: California Entered: 2009-04-20
Recovered? No
Write-up: Information has been received from an office manager that the physician heard Previous Vaccinations:
from the physician's colleague that a 16 year old female colleague's patient was given an Other Medications: Unknown
unspecified dose of GARDASIL (Lot not reported) on a Friday and on Monday the patient Preexisting Conditions: Unknown
passed away (specific dates were unknown). The reporter considered the event as disabling CDC 'Split Type': WAES0904USA02014
and life threatening. Additional information has been requested.

Hospitalized? No
Current Illness:
Write-up: Information has been received via the internet concerning a 21 year old female Other Medications: Unknown
who was vaccinated with GARDASIL. The patient died 4 days after vaccination. The cause Preexisting Conditions: None
of death was unknown. No further information is available. CDC 'Split Type': WAES0904USA03499

Disability? No
Recovered? No
Write-up: Information has been received from a Registered Nurse (R.N) who heard that a 12 Previous Vaccinations:
year old female patient, who on an unspecified date was vaccinated with a dose of Other Medications: Unknown
GARDASIL. It was reported that the patient died on an unspecified date after receiving the Preexisting Conditions: Unknown
vaccine. It was noted that the death occurred over one year ago. Attempts are being made to CDC 'Split Type': WAES0905USA01825
verify the existence of an identifiable patient. Additional information has been requested.

Disability? No
Recovered? No
Write-up: Information has been received from a physician concerning his/her daughter's co- Previous Vaccinations:
worker's daughter who on an unknown date was vaccinated with GARDASIL. It was Other Medications: Unknown
reported that the patient died after receiving a dose of GARDASIL. The cause of death was Preexisting Conditions: Unknown
not reported. Attempts to verify the existence of an identifiable patient and reporter have CDC 'Split Type': WAES0906USA05296
been unsuccessful. No further information is available.

Disability? No
Recovered? No
Write-up: It was reported from an article published on 29-JUN-2009 that there were 27 Previous Vaccinations:
deaths in 2008 said to be associated with GARDASIL. This is one of several reports received Other Medications: Unknown
from the same source. Attempts are being made to obtain additional identifying information Preexisting Conditions: Unknown
to distinguish the individual patients mentioned in this report. Additional information will be CDC 'Split Type': WAES0907USA00328
provided if available.

Disability? No
Recovered? No
Write-up: It was reported from an article published on 29-JUN-2009 that there were 18 Previous Vaccinations:
deaths said to be associated with GARDASIL. This is one of several reports received from Other Medications: Unknown
the same source. Attempts are being made to obtain additional identifying information to Preexisting Conditions: Unknown
distinguish the individual patients mentioned in this report. Additional information will be CDC 'Split Type': WAES0907USA00329
provided if available.

Vaccination Manufacturer Lot Dose Route Site Life Threatening Illness? Yes
HPV4 MERCK & CO. INC. 0 IM UN
Disability? No
Administered by: Unknown Purchased by: Unknown Recovered? No
Symptoms: AIDS encephalopathy, Acute respiratory failure, Aphasia, Blood HIV RNA ER or Doctor Visit? No
increased, Blood pressure fluctuation, Brain death, Brain herniation, Brain oedema, CD4
Hospitalized? Yes, days
lymphocytes decreased, CSF culture negative, CSF glucose decreased, CSF protein
increased, CSF test normal, Cerebrovascular disorder, Computerised tomogram abnormal, Extended hospital stay? No
Condition aggravated, Confusional state, Death, Drug abuse, Dysarthria, Encephalitis, Current Illness: HIV infection
Endotracheal intubation, Facial palsy, HIV antibody positive, HIV infection, Haematocrit Diagnostic Lab Data: head computed axial
decreased, Haemoglobin decreased, Heart rate irregular, Hypoaesthesia, Hyporeflexia, tomography, 06/22/2009, see narrative; spinal
Hypoxic encephalopathy, Kidney fibrosis, Lumbar puncture abnormal, Lymphadenopathy, tap, 06/23/2009, see narrative; spinal tap,
Lymphocyte count decreased, Lymphocyte percentage decreased, Meningeal disorder, 06/23/2009, normalization of glucose; magnetic
Meningitis, Mental status changes, Migraine, Monocyte percentage increased, Neutrophil resonance imaging, 06/23/2009, brain: see
percentage increased, Nuclear magnetic resonance imaging brain abnormal, Pleocytosis, narrative; head computed axial tomography
Pulmonary congestion, Pupil fixed, Red blood cell count decreased, Red blood cell
Previous Vaccinations:
sedimentation rate increased, Spinal cord disorder, Unresponsive to stimuli, Vasculitis
cerebral, White blood cell count decreased Other Medications: None
Write-up: Information has been received from an investigator concerning a 37 year old Preexisting Conditions: Migraine;
female with HIV and a history of migraine headaches and methamphetamine abuse for 20 Amphetamine abuse; Bell's palsy
years who entered a study. On 08-MAY-2009 the patient was enrolled in A5240 and CDC 'Split Type': WAES0907USA01529
vaccinated IM with the first dose of GARDASIL, 0.5ml, in deltoid. On 22-JUN-2009 the
patient developed the following adverse events: altered mental status grade 3 (dysarthria,
anomia, confusion); headache grade 3 (presented to HD 22-JUN-09 with AMS, HA). CT
angle of head showed diffuse cerebral edema); left hand numbness grade 2. On 02-JUL-2009
the patient developed decreased neurological reflexes grade 4 (life threatening), pupils fixed

and dilated bilaterally grade 4 (life threatening), and death. The report was as follows: The
patient presented to emergency department on 22-JUN-2009 with migraine-like headache,
left hand numbness, dysarthria and anomia. CT read as normal, patient discharged, the
patient returned on 23-JUN-2009 with persistent headache, anomia. At that time, she was not
on treatment for HIV and her CD4 count was 263. She was admitted to the neurology service
and empirically treated with antibiotics for bacterial and HSV meningitis. Lumbar puncture
showed borderline low glucose, elevated protein and a lymphocytic pleocytosis without red
blood cells, CSF tests for EBV, HSV, VZV, Cryptococcus, VDRL, AFB smear were
negative as well as CSF culture for bacteria, fungus and mycobacteria. CSF cytology was
negative, flow cytometry was not performed. JC virus PCR was ordered, but results not
reported. Toxoplasma IgG was negative. Blood cultures, coccidioidomycosis titers, serum
cryptococcal antigen, RPR were all negative. Prior quantiferon testing in 2004 was positive
without subsequent isoniazid treatment chest X ray during admission was negative as were 2
sputum for AFB smear and culture. MRI showed diffuse cerebral edema with leptomeningeal
enhancement. Repeated lumbar puncture showed normalization of glucose. During the
hospitalization, her symptoms had improved.

HPV4 MERCK & CO. INC. 1477U 0 IM UN Disability? No
Recovered? No
Symptoms: Asthma, Autopsy, Condition aggravated, Death
Hospitalized? No
Write-up: Information has been received from a gynaecologist concerning an approximate
14 year old female patient with a history of bronchial asthma, who was vaccinated with a Current Illness:
first dose of GARDASIL (lot # not reported) IM into the upper arm on 09-JUN-2009. On 12- Diagnostic Lab Data: Unknown
JUN-2009, the patient experienced an asthmatic attack of which she died. The patient had no Previous Vaccinations:
long-term medication for the asthma but only on occasion. Concomitant medication included Other Medications: hormonal contraceptives
hormonal contraceptives (unspecified). Reportedly, an autopsy was performed. The result is (unspecified)
not yet known. A causal relation to the GARDASIL vaccine was considered unlikely by the
vaccinating physician. Follow-up information received on 22-JUN-2009: Exact birth date, Preexisting Conditions: Asthma bronchial
initials, height (158 cm) and weight (50 kg) as well as lot # 1477U, batch # NH25390 were CDC 'Split Type': WAES0906USA04039
provided. Following information gathered by phone from the reporting physician, the girl
experienced the asthmatic attack at home and an emergency doctor was called. He was not
able to arrest the attack and resuscitation was unsuccessful. Other business partner's numbers
included: E2009-05085.

State: Oklahoma Entered: 2009-09-10 Disability? No
Recovered? No
HPV4 MERCK & CO. INC. 17400 2 IM LA
Hospitalized? No
Administered by: Unknown Purchased by: Unknown Current Illness: None
Symptoms: Arrhythmia, Biopsy heart abnormal, Bronchitis, Chest pain, Chills, Death, Diagnostic Lab Data: None. I do have copies of
Dizziness, Dyspnoea, Fatigue, Feeling cold, Headache, Muscle spasms, Nausea, all medical history from 01/08/2004 to the time
Oropharyngeal pain, Pain, Petechiae, Productive cough, Pulmonary congestion, Pulmonary of her death that I can provide if needed. The
oedema, Pyrexia, Sputum discoloured, Sternal fracture Medical Examiners office will have tissue
Write-up: Headache, Nausea, dizziness, chilling, tiredness, shortness of breath, complained samples until 4/2010.
of chest plain, severe cramps. 9/14/09 Received vaccine & PCP medical records which Previous Vaccinations: None~ ()~~0~Patient
reveal patient seen 12/5/07 & 2/27/08 with sore throat, fever, chills, fatigue, body aches, Other Medications: Yaz until 3/17/08. Femcon
productive cough w/yellow sputum & HA. Dx both times w/acute bronchitis & tx beginning 3/17/08. Anaprox as needed.
w/antibiotics & cough syrup. 9/25/09 Autopsy report received DOD 09/12/2008. Acute
Cardiac Arrhythmia of Unknown Etiology. Addtional information abstracted: Heart with Preexisting Conditions: None
focal microscopic ischemic changes, pulmonary congestion and edema. Rare petechiae: CDC 'Split Type':
conjunctival, periorbital and laryngeal. Resuscitation related sternal fracture.

Disability? No
Recovered? No
Write-up: Information has been received from a nurse practitioners' patient who heard on Previous Vaccinations:
radio that "HPV vaccine killed someone in the country". The cause of death was unknown. Other Medications: Unknown
The reporter was not sure if the vaccine was GARDASIL or CERVARIX. Attempts are Preexisting Conditions: Unknown
being made to verify the existence of an identifiable patient. Additional information has been CDC 'Split Type': WAES0910USA00977
requested.

Age: Onset Date: 0000-00-00 Days later: Died? Yes (date died: 0000-00-00)
Current Illness:
Write-up: Information has been received from an office manager and a consumer who Other Medications: Unknown
reported that she had seen reports of deaths following GARDASIL on television. This is one
of two cases from the same source. This is a hearsay report in the absence of an identifiable Preexisting Conditions: unknown
patient. All telephone attempts to obtain follow up information have been unsuccessful. CDC 'Split Type': WAES0910USA00269

HPV4 MERCK & CO. INC. 2 UN UN Hospitalized? No
Current Illness:
Write-up: Information has been received from a consumer who saw a report on the internet Other Medications: Unknown
about a 23 year old patient who was vaccinated with 3 doses of GARDASIL. Subsequently
the patient died, the cause of the death was unknown. This is one of several reports received Preexisting Conditions: Unknown
from the same source. Additional information has been requested. CDC 'Split Type': WAES0912USA00907

Age: Onset Date: 0000-00-00 Days later: Life Threatening Illness? No
Gender: Submitted: 2009-12-14 Died? Yes (date died: 0000-00-00)
State: Unknown Entered: 2009-12-15 Disability? No
Recovered? No
Hospitalized? No
Write-up: Information has been received from a consumer who saw a report on the internet Previous Vaccinations:
concerning two patients (unspecified ages) who were vaccinated with 3 doses of Other Medications: Unknown
GARDASIL (dates were not reported). Subsequently the patients died, the cause of death
was unknown. This is one of several reports received from the same source. This is a hearsay Preexisting Conditions: Unknown
report, attempts are being made to obtain identifying information to distinguish individual CDC 'Split Type': WAES0912USA01166
patients. Additional information has been requested.

Disability? No
HPV4 MERCK & CO. INC. 1283U 2 IM UN ER or Doctor Visit? No
Hospitalized? No
Current Illness: Herpes virus infection
Symptoms: Sudden death
Write-up: Information has been received from the agency via Case Line listing via CSL, as
part of a business agreement, concerning an 18 year old female patient with disseminated Previous Vaccinations:
herpes viral disease who on 17-MAR-2009 was vaccinated with the third dose of Other Medications: Unknown
GARDASIL (batch #NJ11440, lot# 1283U). The second suspect therapy included DEPO- Preexisting Conditions:
PROVERA which was administered IM, 600 mg yearly, from 2007 October to 2009 January. CDC 'Split Type': WAES0912USA00953
On 22-SEP-2009 the patient developed sudden death (severe). It was unknown if the patient
sought medical attention. A lot check has been initiated. No further information is available.

Gender: Submitted: 2009-12-21 Life Threatening Illness? No
Disability? No
Recovered? No
HPV4 MERCK & CO. INC. UN UN ER or Doctor Visit? No
Administered by: Unknown Purchased by: Unknown Hospitalized? No
Symptoms: Autoimmune disorder, Death Current Illness:
Write-up: Information was reported in a newspaper article that a 14 year old female patient Diagnostic Lab Data: Unknown
who on an unspecified date was vaccinated with a dose of GARDASIL vaccine (lot number, Previous Vaccinations:
date, route and site not reported). Subsequently the patient experienced auto-immune Other Medications: Unknown
symptoms and died 21 months later. The article also discussed the multiple sclerosis of other
5 patient while on therapy with GARDASIL vaccine (WAES 0912USA01664, WAES Preexisting Conditions: Unknown
0912USA02322, WAES 0912USA02323, WAES 0912USA02324, and WAES CDC 'Split Type': WAES0912USA02326
0912USA02325, WAES 0912USA02639, WAES 0912USA02640, WAES 0912USA02641,
WAES 0912USA02642 and WAES 0912USA02643. No further information is available.

Disability? No
HPV4 MERCK & CO. INC. 0859F 0 IM UN ER or Doctor Visit? No
Administered by: Unknown Purchased by: Unknown Hospitalized? Yes, 0 days
Symptoms: Autopsy, Death, Osteitis Extended hospital stay? No
Write-up: Information has been received from a physician concerning a previous healthy 17 Current Illness:
year old female patient with no relevant medical history who on 22-MAY was vaccinated Diagnostic Lab Data: Unknown
intramuscularly with her first dose of GARDASIL (Lot # 654740/0859F) (Batch # NE29660) Previous Vaccinations:
(Injection site was not reported). Concomitant therapy included VALETTE. On 11-JUL-
Other Medications: VALETTE
2007 the reporter was informed by the patient's mother that her daughter was hospitalized
due to bone inflammation. On 15-JUL-2007, approximately 7 weeks post vaccination, the Preexisting Conditions: none
patient died of unknown cause. An autopsy was carried out, but the result was not known to CDC 'Split Type': WAES0912USA02946
the reporter up to the time of reporting. A lot check has been initiated. Other business partner
numbers include E2009-11667. Additional information has been requested.

HPV2 GLAXOSMITHKLINE BIOLOGICALS AHPVA043BB IM UN Life Threatening Illness? No
Disability? No
Symptoms: Anaphylactic reaction, Cardiac arrest, Circulatory collapse, Death, Malaise,
Neoplasm malignant, Ventricular fibrillation Recovered? No
Write-up: This case was reported by a physician and described the occurrence of death nos ER or Doctor Visit? No
in a 14-year-old female subject who was vaccinated with CERVARIX (GlaxoSmithKline). Hospitalized? No
On the morning of the 28 September 2009 the patient received unspecified dose of Current Illness: Unknown
CERVARIX (1 injection). On 28 September, within 30 minutes after vaccination with Diagnostic Lab Data: UNK
CERVARIX, the patient experienced a possible anaphylactic reaction (not confirmed). The
patient collapsed and had to be administered an adrenaline injection. The patient had to be Previous Vaccinations:
resuscitated by the paramedics and was taken to accident and emergency where they made Other Medications: Propranolol hydrochloride;
another attempt to resuscitate the patient. The attempt was not successful and the patient was Lansoprazole; Sumatriptan succinate
declared dead on 28 September 2009. It was unknown whether an autopsy was performed. Preexisting Conditions: No known allergies.
Verbatim text: On the 28th September 2009 a public health consultant reported that a 14 year Was being treated for migraines with propranolol
old female patient was administered a dose of CERVARIX ( Batch: AHPVA043BB, expiry: (unknown dose or presentation) but this has not
09/2010) at school, in the morning of the 28th September 2009 as part of a school been confirmed by patient's GP or family.
immunization program. The consultant reported that within 30 minutes after the CDC 'Split Type': B0595286A
administration of the CERVARIX the patient experienced what they believed was an
anaphylactic reaction (not confirmed). The patient collapsed and had to be administered an
adrenaline injection, she had to be resuscitated by paramedics and was taken to accident and
emergency where they made another attempt to resuscitate the patient but it was not
successful and the patient was declared dead. There was no further information available at
the time of reporting. Follow-up information received via regulatory authority on 30
September 2009: The patient was taking CERVARIX for the prevention of premalignant

cervical lesions and cervical cancer. The patient had no known allergies. She was being
treated for migraines with propranolol (unknown dose or presentation) but his has not been
confirmed by patient's GP or family. The patient received her first dose of CERVARIX
(Batch Number: A1-IPVA043BB) at 10:45 on Monday 28th September

f
Human Papilloma Virus
sudden unexplained death
19 Ys
19.09.2007
Gardasil
--.10.2007
fatal case
2008
9747
2
f
Abdominal pain
Apnoea
Diarrhoea
Photophobia
sudden unexplained death
20 Ys
04.04.2008
GARDASIL
16.08.2008
fatal case
2008
10528
3
f
Erythema infectiosum
Myocarditis
Pulmonary embolism
16 Ys
30.08.2007
GARDASIL
--.10.2007
fatal case
2008
10730
4

f
Gastroschisis
Intra-uterine death
15 Ys
29.12.2008
Gardasil
30.12.2008
fatal case
2009
11803
5
f
Carbon monoxide poisoning
14 Ys
09.06.2009
Gardasil
12.06.2009
fatal case
2009
12908
6
f
Asthma
Brain hypoxia
Bronchostenosis
Cardiac arrest
Dyspnoea
Mydriasis

Addendum
03.06.2010

Gender: Female Submitted: 2010-02-04 Life Threatening Illness? Yes
HPV4 MERCK & CO. INC. 0 IM UN Recovered? No
Hospitalized? No
Symptoms: Death, Drowning, Fall
Current Illness:
Write-up: Information has been received from from a physician concerning a 12 year old
school going girl of class eight of a village. On 20-JUL-2009, the patient received first dose
of GARDASIL in the school. During the process of community mobilization for second dose Previous Vaccinations:
of GARDASIL, the female health worker was informed that on 06-SEP-2009, the patient Other Medications: Unknown
accidentally fell in open well (granite quarry filled with water), drowned and expired. This Preexisting Conditions: Unknown
event occurred 49 days of receiving first dose of GARDASIL. The female health worker CDC 'Split Type': WAES1001USA03763
informed the Medical Officer in-charge, which was then communicated to District
Immunization Officer. The medical officer in-charge investigated the death and completed
first information report and determined that death was not related to the vaccine.


State: Entered: 2010-01-27 Recovered? No
Hospitalized? No
HPV2 GLAXOSMITHKLINE BIOLOGICALS AHPVA050AG 1 IM AR
Current Illness: Unknown
Administered by: Other Purchased by: Other Diagnostic Lab Data: UNK
Symptoms: Death, General physical health deterioration, Headache, Impaired work ability, Previous Vaccinations:
Loss of consciousness, Malaise, Pain in extremity, Pyrexia, Respiratory failure, Snake bite
Other Medications:
Write-up: This case was reported by a physician and described the occurrence of respiratory
Preexisting Conditions: Joint pain
failure in a 15-year-old female subject who was vaccinated with CERVARIX
(GlaxoSmithKline). The subject's medical history included joints pain. Previous and/or CDC 'Split Type': B0628298A
concurrent vaccination included CERVARIX ; GlaxoSmithKline;intramuscular;unknown
deltoid given on 9 September 2009. On 14 October 2009, the subject received 2nd dose of
CERVARIX (intramuscular, unknown deltoid). The subject was put under observation
during 30 minutes after both vaccinations. No adverse event had occurred. On 15 October
2009, 1 day after vaccination with CERVARIX, the subject experienced a low grade fever
and headache. She visited an homeopathy center where she was prescribed treatment with
paracetamol, Liv 52 and RANTAC. The subject was advised to come back to the center for
follow-up after 2 days of treatment. The events resolved and the subject restarted her daily
chores. On 1st November 2009, the subject informed her parents that an insect has bitten her
during the field work. She was not feeling well and complained about leg pain. Post noon,
the subject didn't go to work and rested at home. Overnight, her condition deteriorated. On
the morning of the 2nd November 2009, an ambulance was called. The subject's vital signs
recorded at the time of shifting were poor. On the way to hospital, she became unconscious
and her vital signs were not recordable. The cardio pulmonary resuscitation provided was
unsuccessful. At hospital, she was declared dead due to a respiratory failure. Autopsy was
rejected by the family. The physician considered the events were unrelated to vaccination
with CERVARIX and so, no follow-up was necessary. The subject died on 2 November
2009 from a suspected snake bite. An autopsy was not performed.

Reports of Deaths

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Reports of Deaths

Uploaded by

Copyright:

Available Formats

2.13.

Section VII - Why did my daughter die?

ID Date Age Onset days

03) 275990 0000-00-00 00 Unknown Thrombosis

05) 279592 0000-00-00 00 Unknown Thrombosis

06) 280163 2007-05-04 11 3 Anaphylactic reaction, Cardiac arrest.

07) 282372 2007-06-01 17 0 Sudden death

08) 282747 0000-00-00 00 Unknown Unknown

09) 287888 2007-05-23 22 2 Sudden death

1 Prepared by Janny Stokvis

ID Date Age Onset days

12) 297528 2007-10-06 12 21 Died in her sleep

13) 299377 2007-10-12 16 16 Died in her sleep

16) 307394 2009-03-15 13 85 Possible motor neuron disease

18) 310262 2008-04-05 20 4 cause of death is undetermined.

21) 317757 2008-06-15 15 2 Arrhythmia due to cardiomyopathy

2 Prepared by Janny Stokvis

23) 318491 0000-00-00 00 Unknown allergic reaction to GARDASIL

24) 319533 2008-06-20 21 17 Cardiac arrest, cause undetermined

ID Date Age Onset days

25) 319810 2007-09-20 15 45 COD: Seizure Disorder

26) 320559 0000-00-00 00 (unverified)??

28) 320910 0000-00-00 00 Unknown Unknown

29) 321696 2008-04-07 16 3 Seizures, Cardiac arrest, cause unknown

30) 322250 0000-00-00 22 Unknown Unknown

34) 325151 2008-08-21 20 266 muscle weakness in throat and breathing

35) 334611 2008-12-08 19 12 Found dead in her bed. COD Unkmown

36) 335270 2008-07-16 18 86 ruptured cerebral aneurysm Autopsy on-going

3 Prepared by Janny Stokvis

38) 337797 2007-08-31 18 240 COD-undetermined by autospy and toxicology

39) 338452 German report about German girl. Database PEI

42) 341030 0000-00-00 14 Unknown Unknown

43) 343612 2008-11-26 23 25 hypertrophic cardiomyopathy

44) 343777 0000-00-00 11 Unknown Unknown

46) 344385 0000-00-00 16 Unknown Unknown

47) 345435 0000-00-00 21 4 Unknown

48) 346674 0000-00-00 12 Unknown

49) 350666 0000-00-00 00 Unknown Unknown

50) 350967 0000-00-00 00 (unverified)??

4 Prepared by Janny Stokvis

52) 351970 2009-06-22 37 45 Meningitis or other??

ID Date Age Onset days

53) 350228 2009-06-12 14 3 asthmatic attack of which she died

54) 356938 2008-09-12 19 53 Acute Cardiac Arrhythmia of Unknown Etiology.

55) 361121 0000-00-00 00 (unverified)??

56) 361629 0000-00-00 00 Hearsay report!

58) 373315 0000-00-00 00 Hearsay report!

59) 372910 2009-09-22 18 189 Sudden death

60) 374780 0000-00-00 14 (unverified)??

VAERS HPV2 Report from the UK

62) 363051 2009-09—28 14 0 Anaphylactic reaction, Cardiac arrest

5 Prepared by Janny Stokvis

63) 8567 2007-05-22 17 Sudden unexplained death.

ID Date Age Onset days

64) 9747 2007-10-.. 19 Sudden unexplained death

65) 10528 2008-08-16 20 Myocarditis, Pulmonary Embolism

66) 11802 2008-12-29 15 Carbon Monoxide poisoning (VAERS ID 338452)

67) 12908 2009-06-12 14 Cardiac arrest

68) No access to report 18 Sudden death

6 Prepared by Janny Stokvis

7 Prepared by Janny Stokvis

8 Prepared by Janny Stokvis

9 Prepared by Janny Stokvis