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This is VAERS ID 264376

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 264376
Age:22.0
Gender:Female
Location:Arizona
Vaccinated:2006-08-30
Onset:2006-09-02
Submitted:2006-10-06
Entered:2006-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. - / - UN / -

Administered by: Other      Purchased by: Unknown
Symptoms: Aphthous stomatitis, Herpes simplex, Malaise, Myalgia, Nausea

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: Body temp 9/6/06 102F, body temp 9/8/06 98.9F.
CDC 'Split Type':

Write-up:Information has been received from a physician concerning a 22 year old female with no pertinent medical history and no allergies, who on 8/30/06 was vaccinated with HPV rL1 6 11 16 18 VLP vaccine yeast. On 9/2/06 the pt developed a canker sore on her lip"and sore throat. On 9/6/06 she experienced nausea, vomiting, malaise, a temperature of 102F and developed a herpetic ulcerative ring on her left ring finger. It was also reported that the pt experienced myalgia. Unspecified medical attention was sought/ S


Changed on 12/8/2009

VAERS ID: 264376 Before After
Age:22.0
Gender:Female
Location:Arizona
Vaccinated:2006-08-30
Onset:2006-09-02
Submitted:2006-10-06
Entered:2006-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) HPV (GARDASIL) / MERCK & CO. INC. - / - UN / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Aphthous stomatitis, Herpes simplex, Malaise, Myalgia, Nausea, Pharyngolaryngeal pain, Pyrexia, Skin ulcer, Vomiting

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: Body temp 9/6/06 102F, body temp 9/8/06 98.9F.
CDC 'Split Type': (blank) WAES0609USA01979

Write-up:Information has been received from a physician concerning a 22 year old female with no pertinent medical history and no allergies, who on 8/30/06 was vaccinated with HPV rL1 6 11 16 18 VLP vaccine yeast. On 9/2/06 the pt developed a canker sore on her lip"and lip and sore throat. On 9/6/06 she experienced nausea, vomiting, malaise, a temperature of 102F and developed a herpetic ulcerative ring on her left ring finger. It was also reported that the pt experienced myalgia. Unspecified medical attention was sought/ S Subsequently, it was reported on 9/8/06 that the symptoms were subsiding, the lesion on the pts lip had crusted and her temp was 98.9F.


Changed on 2/5/2010

VAERS ID: 264376 Before After
Age:22.0
Gender:Female
Location:Arizona
Vaccinated:2006-08-30
Onset:2006-09-02
Submitted:2006-10-06
Entered:2006-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - 0 UN / - IM

Administered by: Other Private      Purchased by: Other Private
Symptoms: Aphthous stomatitis, Herpes simplex, Malaise, Myalgia, Nausea, Pharyngolaryngeal pain, Pyrexia, Skin ulcer, Vomiting

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: Body temp 9/6/06 102F, Herpes simplex virus, 09/13/06, Oral T 1 +; Herpes simplex virus, 09/13/06, Finger T 1 +; body temp, 09/06/06, 102F; body temp 9/8/06 09/08/06, 98.9F.
CDC 'Split Type': WAES0609USA01979

Write-up:Information has been received from a physician concerning a 22 year old female with no pertinent medical history and no allergies, who on 8/30/06 was vaccinated with HPV rL1 6 11 16 18 VLP vaccine yeast. On 9/2/06 the pt developed a canker sore on her lip and sore throat. On 9/6/06 she experienced nausea, vomiting, malaise, a temperature of 102F and developed a herpetic ulcerative ring on her left ring finger. It was also reported that the pt experienced myalgia. Unspecified medical attention was sought/ Subsequently, it was reported on 9/8/06 that the symptoms were subsiding, the lesion on the pts lip had crusted and her temp was 98.9F. 01/05/2007 Follow up information received stated that on 02-SEP-2006 the patient also developed gastrointestinal upset. Lab work completed on 13-SEP-06 included positive cultures for Herpes simplex type 1 isolated in oral swab and on the patients finger. At the time of this report it was unknown if the patient had recovered from the event. Additional information has been requested.


Changed on 7/31/2010

VAERS ID: 264376 Before After
Age:22.0
Gender:Female
Location:Arizona
Vaccinated:2006-08-30
Onset:2006-09-02
Submitted:2006-10-06
Entered:2006-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / IM

Administered by: Private      Purchased by: Private
Symptoms: Abdominal discomfort, Aphthous stomatitis, Herpes simplex, Malaise, Myalgia, Nausea, Pharyngolaryngeal pain, Pyrexia, Skin ulcer, Vomiting

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: Herpes simplex virus, 09/13/06, Oral T 1 +; Herpes simplex virus, 09/13/06, Finger T 1 +; body temp, 09/06/06, 102F; body temp 09/08/06, 98.9F.
CDC 'Split Type': WAES0609USA01979

Write-up:Information has been received from a physician concerning a 22 year old female with no pertinent medical history and no allergies, who on 8/30/06 was vaccinated with HPV rL1 6 11 16 18 VLP vaccine yeast. On 9/2/06 the pt developed a canker sore on her lip and sore throat. On 9/6/06 she experienced nausea, vomiting, malaise, a temperature of 102F and developed a herpetic ulcerative ring on her left ring finger. It was also reported that the pt experienced myalgia. Unspecified medical attention was sought/ Subsequently, it was reported on 9/8/06 that the symptoms were subsiding, the lesion on the pts lip had crusted and her temp was 98.9F. 01/05/2007 Follow up information received stated that on 02-SEP-2006 the patient also developed gastrointestinal upset. Lab work completed on 13-SEP-06 included positive cultures for Herpes simplex type 1 isolated in oral swab and on the patients finger. At the time of this report it was unknown if the patient had recovered from the event. Additional information has been requested.


Changed on 8/31/2010

VAERS ID: 264376 Before After
Age:22.0
Gender:Female
Location:Arizona
Vaccinated:2006-08-30
Onset:2006-09-02
Submitted:2006-10-06
Entered:2006-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / IM

Administered by: Private      Purchased by: Private
Symptoms: Abdominal discomfort, Aphthous stomatitis, Herpes simplex, Malaise, Myalgia, Nausea, Pharyngolaryngeal pain, Pyrexia, Skin ulcer, Vomiting, Oropharyngeal pain

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: Herpes simplex virus, 09/13/06, Oral T 1 +; Herpes simplex virus, 09/13/06, Finger T 1 +; body temp, 09/06/06, 102F; body temp 09/08/06, 98.9F.
CDC 'Split Type': WAES0609USA01979

Write-up:Information has been received from a physician concerning a 22 year old female with no pertinent medical history and no allergies, who on 8/30/06 was vaccinated with HPV rL1 6 11 16 18 VLP vaccine yeast. On 9/2/06 the pt developed a canker sore on her lip and sore throat. On 9/6/06 she experienced nausea, vomiting, malaise, a temperature of 102F and developed a herpetic ulcerative ring on her left ring finger. It was also reported that the pt experienced myalgia. Unspecified medical attention was sought/ Subsequently, it was reported on 9/8/06 that the symptoms were subsiding, the lesion on the pts lip had crusted and her temp was 98.9F. 01/05/2007 Follow up information received stated that on 02-SEP-2006 the patient also developed gastrointestinal upset. Lab work completed on 13-SEP-06 included positive cultures for Herpes simplex type 1 isolated in oral swab and on the patients finger. At the time of this report it was unknown if the patient had recovered from the event. Additional information has been requested.


Changed on 1/4/2011

VAERS ID: 264376 Before After
Age:22.0
Gender:Female
Location:Arizona
Vaccinated:2006-08-30
Onset:2006-09-02
Submitted:2006-10-06
Entered:2006-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / IM

Administered by: Private      Purchased by: Private
Symptoms: Abdominal discomfort, Aphthous stomatitis, Herpes simplex, Malaise, Myalgia, Nausea, Pharyngolaryngeal pain, Pyrexia, Skin ulcer, Vomiting, Oropharyngeal pain

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: Herpes simplex virus, 09/13/06, Oral T 1 +; Herpes simplex virus, 09/13/06, Finger T 1 +; body temp, 09/06/06, 102F; body temp 09/08/06, 98.9F.
CDC 'Split Type': WAES0609USA01979

Write-up:Information has been received from a physician concerning a 22 year old female with no pertinent medical history and no allergies, who on 8/30/06 was vaccinated with HPV rL1 6 11 16 18 VLP vaccine yeast. On 9/2/06 the pt developed a canker sore on her lip and sore throat. On 9/6/06 she experienced nausea, vomiting, malaise, a temperature of 102F and developed a herpetic ulcerative ring on her left ring finger. It was also reported that the pt experienced myalgia. Unspecified medical attention was sought/ Subsequently, it was reported on 9/8/06 that the symptoms were subsiding, the lesion on the pts lip had crusted and her temp was 98.9F. 01/05/2007 Follow up information received stated that on 02-SEP-2006 the patient also developed gastrointestinal upset. Lab work completed on 13-SEP-06 included positive cultures for Herpes simplex type 1 isolated in oral swab and on the patients finger. At the time of this report it was unknown if the patient had recovered from the event. Additional information has been requested.


Changed on 6/14/2014

VAERS ID: 264376 Before After
Age:22.0
Gender:Female
Location:Arizona
Vaccinated:2006-08-30
Onset:2006-09-02
Submitted:2006-10-06
Entered:2006-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / IM

Administered by: Private      Purchased by: Private
Symptoms: Abdominal discomfort, Aphthous stomatitis, Herpes simplex, Malaise, Myalgia, Nausea, Pharyngolaryngeal pain, Pyrexia, Skin ulcer, Vomiting

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: Herpes simplex virus, 09/13/06, Oral T 1 +; Herpes simplex virus, 09/13/06, Finger T 1 +; body temp, 09/06/06, 102F; body temp 09/08/06, 98.9F.
CDC 'Split Type': WAES0609USA01979

Write-up:Information has been received from a physician concerning a 22 year old female with no pertinent medical history and no allergies, who on 8/30/06 was vaccinated with HPV rL1 6 11 16 18 VLP vaccine yeast. On 9/2/06 the pt developed a canker sore on her lip and sore throat. On 9/6/06 she experienced nausea, vomiting, malaise, a temperature of 102F and developed a herpetic ulcerative ring on her left ring finger. It was also reported that the pt experienced myalgia. Unspecified medical attention was sought/ Subsequently, it was reported on 9/8/06 that the symptoms were subsiding, the lesion on the pts lip had crusted and her temp was 98.9F. 01/05/2007 Follow up information received stated that on 02-SEP-2006 the patient also developed gastrointestinal upset. Lab work completed on 13-SEP-06 included positive cultures for Herpes simplex type 1 isolated in oral swab and on the patients finger. At the time of this report it was unknown if the patient had recovered from the event. Additional information has been requested.


Changed on 3/14/2015

VAERS ID: 264376 Before After
Age:22.0
Gender:Female
Location:Arizona
Vaccinated:2006-08-30
Onset:2006-09-02
Submitted:2006-10-06
Entered:2006-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / IM

Administered by: Private      Purchased by: Private
Symptoms: Abdominal discomfort, Aphthous stomatitis, Herpes simplex, Malaise, Myalgia, Nausea, Pharyngolaryngeal pain, Pyrexia, Skin ulcer, Vomiting

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: Herpes simplex virus, 09/13/06, Oral T 1 +; Herpes simplex virus, 09/13/06, Finger T 1 +; body temp, 09/06/06, 102F; body temp 09/08/06, 98.9F.
CDC 'Split Type': WAES0609USA01979

Write-up:Information has been received from a physician concerning a 22 year old female with no pertinent medical history and no allergies, who on 8/30/06 was vaccinated with HPV rL1 6 11 16 18 VLP vaccine yeast. On 9/2/06 the pt developed a canker sore on her lip and sore throat. On 9/6/06 she experienced nausea, vomiting, malaise, a temperature of 102F and developed a herpetic ulcerative ring on her left ring finger. It was also reported that the pt experienced myalgia. Unspecified medical attention was sought/ Subsequently, it was reported on 9/8/06 that the symptoms were subsiding, the lesion on the pts lip had crusted and her temp was 98.9F. 01/05/2007 Follow up information received stated that on 02-SEP-2006 the patient also developed gastrointestinal upset. Lab work completed on 13-SEP-06 included positive cultures for Herpes simplex type 1 isolated in oral swab and on the patients finger. At the time of this report it was unknown if the patient had recovered from the event. Additional information has been requested.


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