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This is VAERS ID 283521

Case Details

VAERS ID: 283521 (history)  
Form: Version 1.0  
Age: 12.0  
Gender: Female  
Location: Maine  
Submitted: 2007-06-29
Entered: 2007-07-02
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Blindness transient, Dizziness, Mydriasis
SMQs:, Anticholinergic syndrome (broad), Embolic and thrombotic events, arterial (narrow), Glaucoma (broad), Optic nerve disorders (broad), Retinal disorders (broad), Vestibular disorders (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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0706USA04134

Write-up: Information has been received from a physician, via a company representative, concerning a 12 year old female patient, who was vaccinated (date not specified) with the first dose of Gardasil, and following vaccination, felt like she was going to faint. The physician confirmed that the patient did not actually faint, though she had dilated pupils and she "lost sight" for approximately 10 minutes. The patient was instructed to lie down for 10 minutes, and then reported "she was okay." Upon internal review, "lost sight for approximately 10 minutes," was determined to be serious as an other important medical event. Additional information has been requested.

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