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This is VAERS ID 270061

Case Details

VAERS ID: 270061 (history)  
Form: Version 1.0  
Age: 19.0  
Gender: Female  
Location: Florida  
Vaccinated:2006-12-21
Onset:2006-12-21
   Days after vaccination:0
Submitted: 2007-01-03
   Days after onset:13
Entered: 2007-01-04
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / -

Administered by: Other       Purchased by: Other
Symptoms: Blindness transient, Dizziness, Headache, Pallor
SMQs:, Anticholinergic syndrome (broad), Embolic and thrombotic events, arterial (narrow), Glaucoma (broad), Optic nerve disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)

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: NONE
Current Illness:
Preexisting Conditions: CONCURRENT CONDITIONS: Drug hypersensitivity
Allergies:
Diagnostic Lab Data:
CDC Split Type: WAES0612USA03857

Write-up: information has been received from the mother of a 19 year old female with a drug hypersensitivity to unspecified antibiotics. On 21 Dec 2006, the patient was vaccinated with the first dose of HPV vaccine. There were no concomitant medications reported. On 21 Dec 2006, the patient felt like her head was going to burst, she looked pale and was possibly going to faint. The patient developed temporary blindness that lasted about two minutes. The patient sought unspecified medical attention. On 21 Dec 2006, the patient had recovered from the events, "after a few minutes". Upon internal review, the temporary blindness was considered to be an other important medical event (OMIC). Additional information has been requested.


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