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This is VAERS ID 275989

Case Details

VAERS ID: 275989 (history)  
Form: Version 1.0  
Age: 16.0  
Gender: Female  
Location: New York  
Vaccinated:2007-01-29
Onset:2007-02-08
   Days after vaccination:10
Submitted: 2007-04-10
   Days after onset:60
Entered: 2007-04-11
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1424K / UNK LA / IM

Administered by: Other       Purchased by: Other
Symptoms: Diplopia, Optic neuritis, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Optic nerve disorders (narrow), Demyelination (narrow), Lens disorders (broad), Retinal disorders (broad), Ocular infections (broad), Ocular motility disorders (broad), Hypoglycaemia (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? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None records received 5/29/07-H/O migraines.
Allergies:
Diagnostic Lab Data: Unknown records received 5/29/07-MRI no significant abnormalities. CSF clear. coloreless 0 RBC 1 WBC. CSF culture gram positive bacilli. no organisms seen on gram stain.
CDC Split Type: WAES0704USA00603

Write-up: Information has been received from a licensed practical nurse concerning a 16 year old female with no pertinent medical history who on 29-JAN-2007 was vaccinated, intramuscularly , into the left deltoid, with a 0.5 ml dose of GARDASIL (lot #"1424K"). There was no concomitant medication. On 08-FEB-2007 the patient developed optic neuritis, blurred vision and double vision and was hospitalized. The patient was discharged from the hospital on 13-FEB-2007 when her vision returned to normal. At the time of the report, the patient was recovering under the care of a retinoligist. Additional information has been requested. 05/29/07-records received for DOS 2/8-2/11/07-DX blurry vision left eye. Seen by ophtho on day of admission fr optic neuritis vs. pseudotumor cerebri. Acute onset of painless blurry vision left eye and seeing double for one day. No headache.


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