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This is VAERS ID 263218

Case Details

VAERS ID: 263218 (history)  
Form: Version 1.0  
Age: 52.0  
Gender: Female  
Location: California  
   Days after vaccination:0
Submitted: 2007-01-06
   Days after onset:163
Entered: 2006-09-19
   Days after submission:109
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 - / IM

Administered by: Private       Purchased by: Other
Symptoms: Injection site reaction

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Herpes labialis
Preexisting Conditions: Herpes virus infection
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0608USA04520

Write-up: This is in follow-up to report(s) previously submitted on 9/14/2006. Initial and follow-up information has been received from a physician concerning a 52 year old female with a history of a "herpes outbreak" two weeks ago. On 17-JUL-2006. "10 days prior" to receiving GARDASIL (yeast), the patient had taken acyclovir 200 mg. On 27-JUL-2006, the patient was vaccinated intramuscularly with the first dose of 0.5 mL of GARDASIL (yeast). It was reported that the patient had "2 herpes lesions on her inner labia" at the time of vaccination. On 27-JUL-2006, the patient developed a neck ache, eyelashes fell out, "a decrease memory for people" and excessive dry eye. On 27-AUG-2006 the patient developed a migraine with vomiting (previously reported that the patient had "burning at the injection site"). The patient sought unspecified medical attention. At the time of this report, the patient had recovered from the events (date unknown). Additional information has been requested.

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