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This is VAERS ID 269633

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

269633
VAERS Form:
Age:18.0
Gender:Female
Location:Unknown
Vaccinated:2006-09-14
Onset:2006-11-01
Submitted:2006-12-19
Entered:2006-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. 0800F / - - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Dry eye, Visual disturbance

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: Yasmin
Current Illness:
Preexisting Conditions: Dysfunctional uterine bleeding, Anemia.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Information has been received from a medical assistant concerning an 18 year old female with a history of dysfunctional uterine bleeding (DUB) and anaemia who on 14 Sep 2006 was vaccinated with HPV vaccine (lot 0800F, batch 654540), 0.5 ml, IM, once. Conc"omitant therapy included Yasmin. In approximately November 2006 (last couple weeks), the patient experienced extreme eye dryness after receiving HPV vaccine. The patient''''s eye was so dry that she had a hard time seeing. On an unspecified date, the patien


Changed on 12/8/2009

269633 Before After
VAERS Form:
Age:18.0
Gender:Female
Location:Unknown
Vaccinated:2006-09-14
Onset:2006-11-01
Submitted:2006-12-19
Entered:2006-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) HPV (GARDASIL) / MERCK & CO. INC. 0800F / - - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Dry eye, Visual disturbance

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: Yasmin
Current Illness:
Preexisting Conditions: Dysfunctional uterine bleeding, Anemia.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) WAES0612USA01371

Write-up:Information has been received from a medical assistant concerning an 18 year old female with a history of dysfunctional uterine bleeding (DUB) and anaemia who on 14 Sep 2006 was vaccinated with HPV vaccine (lot 0800F, batch 654540), 0.5 ml, IM, once. Conc"omitant Concomitant therapy included Yasmin. In approximately November 2006 (last couple weeks), the patient experienced extreme eye dryness after receiving HPV vaccine. The patient''''s patient''s eye was so dry that she had a hard time seeing. On an unspecified date, the patien patient sought unspecified medical attention. Eventually, the patient had a duct implant put in her eyes by a specialist to help with the dryness. The patient was recovering from the event of extreme eye dryness. Extreme eye dryness was considered to be disabling and an other important medical event (OMIC). Additional information has been requested.


Changed on 6/14/2014

269633 Before After
VAERS Form:
Age:18.0
Gender:Female
Location:Unknown
Vaccinated:2006-09-14
Onset:2006-11-01
Submitted:2006-12-19
Entered:2006-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0800F / - - / IM

Administered by: Other      Purchased by: Other
Symptoms: Dry eye, Visual disturbance

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: Yasmin
Current Illness:
Preexisting Conditions: Dysfunctional uterine bleeding, Anemia.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0612USA01371

Write-up:Information has been received from a medical assistant concerning an 18 year old female with a history of dysfunctional uterine bleeding (DUB) and anaemia who on 14 Sep 2006 was vaccinated with HPV vaccine (lot 0800F, batch 654540), 0.5 ml, IM, once. Concomitant therapy included Yasmin. In approximately November 2006 (last couple weeks), the patient experienced extreme eye dryness after receiving HPV vaccine. The patient''s eye was so dry that she had a hard time seeing. On an unspecified date, the patient sought unspecified medical attention. Eventually, the patient had a duct implant put in her eyes by a specialist to help with the dryness. The patient was recovering from the event of extreme eye dryness. Extreme eye dryness was considered to be disabling and an other important medical event (OMIC). Additional information has been requested.


Changed on 5/14/2017

269633 Before After
VAERS Form:
Age:18.0
Gender:Female
Location:Unknown
Vaccinated:2006-09-14
Onset:2006-11-01
Submitted:2006-12-19
Entered:2006-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0800F / - - / IM

Administered by: Other      Purchased by: Other
Symptoms: Dry eye, Visual disturbance

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: Yasmin
Current Illness:
Preexisting Conditions: Dysfunctional uterine bleeding, Anemia.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0612USA01371

Write-up:Information has been received from a medical assistant concerning an 18 year old female with a history of dysfunctional uterine bleeding (DUB) and anaemia who on 14 Sep 2006 was vaccinated with HPV vaccine (lot 0800F, batch 654540), 0.5 ml, IM, once. Concomitant therapy included Yasmin. In approximately November 2006 (last couple weeks), the patient experienced extreme eye dryness after receiving HPV vaccine. The patient''s eye was so dry that she had a hard time seeing. On an unspecified date, the patient sought unspecified medical attention. Eventually, the patient had a duct implant put in her eyes by a specialist to help with the dryness. The patient was recovering from the event of extreme eye dryness. Extreme eye dryness was considered to be disabling and an other important medical event (OMIC). Additional information has been requested.


Changed on 9/14/2017

269633 Before After
VAERS Form:(blank) 1
Age:18.0
Gender:Female
Location:Unknown
Vaccinated:2006-09-14
Onset:2006-11-01
Submitted:2006-12-19
Entered:2006-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0800F / - UNK - / IM

Administered by: Other      Purchased by: Other
Symptoms: Dry eye, Visual disturbance

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: Yasmin
Current Illness:
Preexisting Conditions: Dysfunctional uterine bleeding, Anemia.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0612USA01371

Write-up:Information has been received from a medical assistant concerning an 18 year old female with a history of dysfunctional uterine bleeding (DUB) and anaemia who on 14 Sep 2006 was vaccinated with HPV vaccine (lot 0800F, batch 654540), 0.5 ml, IM, once. Concomitant therapy included Yasmin. In approximately November 2006 (last couple weeks), the patient experienced extreme eye dryness after receiving HPV vaccine. The patient''s eye was so dry that she had a hard time seeing. On an unspecified date, the patient sought unspecified medical attention. Eventually, the patient had a duct implant put in her eyes by a specialist to help with the dryness. The patient was recovering from the event of extreme eye dryness. Extreme eye dryness was considered to be disabling and an other important medical event (OMIC). Additional information has been requested.


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