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This is VAERS ID 369063

Case Details

VAERS ID: 369063 (history)  
Form: Version 1.0  
Gender: Female  
Location: Foreign  
   Days after vaccination:0
Submitted: 2009-11-19
   Days after onset:110
Entered: 2009-11-20
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Unknown       Purchased by: Unknown
Symptoms: Embolism venous, Visual impairment
SMQs:, Anticholinergic syndrome (broad), Embolic and thrombotic events, venous (narrow), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0911USA02488

Write-up: Information has been received from a physician concerning a $g40 year old female, who in August 2009, was vaccinated IM with 0.5 ml first dose of GARDASIL (dose and lot number not reported). This report was part of a study. Two months after the vaccination (approximately in October 2009), the patient had a visual problem that after consulting with her ophthalmologist, the patient was diagnosed with eye thromboemboli. The patient went to the physician for medical care and the visual problem was only recovered by 10%. In October 2009, the patient went again to the physician for medical care but seeing a different doctor and the patient was diagnosed with venous thromboemboli. At the time of the report the outcome of the patient was not recovered. At this time, relationship of eye thromboemboli vena to study therapy is unknown. The physician felt that the Thrombo emboli vena was considered to be disabling. Additional information has been expected.

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