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This is VAERS ID 658798

Case Details

VAERS ID: 658798 (history)  
Form: Version 1.0  
Age: 52.0  
Gender: Female  
Location: Vermont  
Vaccinated:2016-07-25
Onset:2016-08-04
   Days after vaccination:10
Submitted: 2016-10-12
   Days after onset:69
Entered: 2016-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS 9GE5D / UNK LA / IM

Administered by: Unknown       Purchased by: Other
Symptoms: Hypoaesthesia, Myelitis transverse, Nasopharyngitis, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Demyelination (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Initially felt cold-like symptoms. Mild reaction. Then, peripheral numbness and tingling began on or around 8/22/2016. Developed into transverse myelitis affecting lower extremities, upper extremities and thorax. Was seen at hospital.


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