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This is VAERS ID 275989

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 275989
Age:16.0
Gender:Female
Location:New York
Vaccinated:2007-01-29
Onset:2007-02-08
Submitted:2007-04-10
Entered:2007-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: CSF culture positive, Diplopia, Nuclear magnetic resonance imaging brain normal, Optic neuritis, CSF test

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: Unknown
CDC 'Split Type':

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/"). Th"ere 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


Changed on 12/8/2009

VAERS ID: 275989 Before After
Age:16.0
Gender:Female
Location:New York
Vaccinated:2007-01-29
Onset:2007-02-08
Submitted:2007-04-10
Entered:2007-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - 1424K / - - LA / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: CSF culture positive, Diplopia, Nuclear magnetic resonance imaging brain normal, Optic neuritis, Vision blurred, CSF test

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None records received 5/29/07-H/O migraines.
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': (blank) 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 GARDASIL (lot #/"1424K/"). Th"ere #"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.


Changed on 5/14/2017

VAERS ID: 275989 Before After
Age:16.0
Gender:Female
Location:New York
Vaccinated:2007-01-29
Onset:2007-02-08
Submitted:2007-04-10
Entered:2007-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1424K / - LA / IM

Administered by: Other      Purchased by: Other
Symptoms: CSF culture positive, Diplopia, Nuclear magnetic resonance imaging brain normal, Optic neuritis, Vision blurred, CSF test

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None records received 5/29/07-H/O migraines.
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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