Write-up: This spontaneous report (initial receipt: 08-FEB-2011) concerns a 13 year old female patient, who had a medical history of asthma, environment allergies and an anxiety disorder. The patient did not have any illness at the time of vaccination. On 27-OCT-2008 the patient received a Flu vaccine (brand name unspecified). The patient also received intramuscular GARDASIL (batch number: 0279X) on the same day. She received her third dose of GARDASIL (batch number: 0570X) on 26-MAY-2009. On 09-MAR-2009, 134 days after flu vaccination, the patient was found to have elevated optic nerve (on examination). Subsequently she had a positive ANA test twice and elevated anti-SSB antibody associated with Sjogren''s syndrome, but no eye symptoms. The patient outcome was not provided.