According to a global Periodic Safety Update Report (PSUR)¹ produced by Merck, who manufacture Gardasil and Gardasil 9, there were 21 reports of deaths after HPV vaccination in a six-month period in 2018.In one case, the patient received five HPV vaccinations whereas three is the recommended maximum number.The company admits that it seems “biologically plausible” that non-specific immune stimuli, including vaccinations, could precede cases of Immune Thrombocytopenic Purpura (ITP) in susceptible individuals, but insists that there is insufficient evidence to infer that HPV vaccination can cause ITP.Merck also reports the case of a six-week-old baby being accidentally vaccinated with quadrivalent Gardasil and cases of HPV vaccination during pregnancy.The PSUR, which covers a six-month reporting period from June 10 to December 9, 2018, was submitted by Merck to the European Medicines Agency (EMA).It states that, during the reporting period, 21 case reports of fatal outcome in a HPV vaccine recipient were identified.In the case of one of the deaths, and in numerous cases of reported illness after HPV vaccination, the patient was given several different vaccines at the same time. These include the DTP vaccine, FluMist, Boostrix, Infanrix hexa, the MMR vaccine, the Hib vaccine, and the the Menactra meningococcal conjugate vaccine.Nineteen of the cases of fatalities were “spontaneous reports” and two were from “noninterventional study reports”.Four of the 19 spontaneous reports contained very limited information, Merck states. Three of them were medically confirmed and one was “consumer reported”. One of these deaths was that of a 15-year-old female and another was a female patient “between 20 and 21 years old”, who developed liver failure.In one of the medically confirmed cases, the patient received five doses of Gardasil 9 and/or quadrivalent Gardasil “and subsequently experienced serious complications (not further specified) and died”, Merck stated.