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This is VAERS ID 397569

Case Details

VAERS ID: 397569 (history)  
Form: Version 1.0  
Age: 13.0  
Gender: Female  
Location: Alabama  
   Days after vaccination:7
Submitted: 2010-09-03
   Days after onset:10
Entered: 2010-09-07
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Unknown       Purchased by: Unknown
Symptoms: Blindness, Headache, Ophthalmological examination abnormal, Vision blurred, Visual field defect, Visual impairment
SMQs:, Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Corneal 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? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: ophthalmological exam, 08/??/10, visual field deficits
CDC Split Type: WAES1008USA03618

Write-up: Information has been received from a physician concerning a 13 year old female with no pertinent medical history and no known allergies who was vaccinated IM with the first 0.5 ml dose and the second 0.5 ml dose of GARDASIL (lot # of both doses not reported) on 15-JUN-2010 and 17-AUG-2010, respectively. There was no concomitant medication. On 24-AUG-2010, the patient experienced blurred vision, seeing spots and a headache. The physician reports that the patient was seen by an optometrist who performed vision exam and noted visual field deficits, and that patient was scheduled for an MRI on 26-AUG-2010. It was also reported that the patient had vision loss. At the time of the report, the patient was not recovered. Vision loss was considered to be disabling by the reporting physician. Additional information has been requested.

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