|
VAERS ID: |
99006 (history) |
Form: |
Version 1.0 |
Age: |
73.0 |
Sex: |
Male |
Location: |
New York |
Vaccinated: | 1996-10-02 |
Onset: | 1996-10-05 |
Days after vaccination: | 3 |
Submitted: |
0000-00-00 |
Entered: |
1997-06-13 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH |
4968185 / UNK |
- / IM |
Administered by: Unknown Purchased by: Unknown Symptoms: Laboratory test abnormal,
Muscle atrophy,
Neuropathy,
Pain SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Immune-mediated/autoimmune disorders (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: ~ ()~~~In patient Other Medications: Prilosec & propulsid on reg basis Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: EMG affected on axillary suprascapular, median nerves; CDC Split Type:
Write-up: lt arm pain-same arm as flu shot;supra? deltoid atrophy;EMG affected on axillary suprascapular, median nerve; |
|
VAERS ID: |
99365 (history) |
Form: |
Version 1.0 |
Age: |
72.0 |
Sex: |
Female |
Location: |
Georgia |
Vaccinated: | 1996-11-02 |
Onset: | 1996-11-19 |
Days after vaccination: | 17 |
Submitted: |
0000-00-00 |
Entered: |
1997-06-30 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER |
- / UNK |
- / - |
Administered by: Unknown Purchased by: Unknown Symptoms: Asthenia,
Guillain-Barre syndrome,
Hyperchloraemia,
Hyperglycaemia,
Hypoxia,
Laboratory test abnormal,
Quadriplegia SMQs:, Asthma/bronchospasm (broad), Peripheral neuropathy (narrow), Hyperglycaemia/new onset diabetes mellitus (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (narrow), Demyelination (narrow), Eosinophilic pneumonia (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Tubulointerstitial diseases (broad), Respiratory failure (broad), Infective pneumonia (broad), Immune-mediated/autoimmune disorders (narrow)
Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
Extended hospital stay? No
Previous Vaccinations: Other Medications: Current Illness: upper resp sx 3wk prior to admission; Preexisting Conditions: PMH x/hysterectomy 50yrs PTA; Allergies: Diagnostic Lab Data: CBC WNL; 9.3/39.1;13.5;321; 138/3.7/108/23.4/6/0.7;139; CDC Split Type:
Write-up: pt recv vax & became weaker during the day,upon admission was markedly quadraparetic;could move head & speaks w/diff;CBC WNL;adm w/GBS;intubated on ventilator;tracheostomy performed 24NOV96; |
|
VAERS ID: |
99823 (history) |
Form: |
Version 1.0 |
Age: |
72.0 |
Sex: |
Female |
Location: |
Georgia |
Vaccinated: | 1996-11-01 |
Onset: | 1996-11-19 |
Days after vaccination: | 18 |
Submitted: |
0000-00-00 |
Entered: |
1997-07-07 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER |
- / UNK |
- / - |
Administered by: Unknown Purchased by: Unknown Symptoms: Dysphagia,
Guillain-Barre syndrome,
Hyperchloraemia,
Hyperglycaemia,
Hypokinesia,
Hypoxia,
Laboratory test abnormal,
Quadriplegia SMQs:, Asthma/bronchospasm (broad), Peripheral neuropathy (narrow), Hyperglycaemia/new onset diabetes mellitus (narrow), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Demyelination (narrow), Eosinophilic pneumonia (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypotonic-hyporesponsive episode (broad), Tubulointerstitial diseases (broad), Respiratory failure (broad), Infective pneumonia (broad), Immune-mediated/autoimmune disorders (narrow)
Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: PMH x/hystercetomy-50yr PTA:upper resp Allergies: Diagnostic Lab Data: CBC WNL; 9.3;39.1;13.5;321; Na 138;Potassium 3.7;Cl 108;Bicarb 23.4;BUN 6;Creat 0.7; glucose 139; CDC Split Type:
Write-up: pt recv vax & became weaker during the day;upon admission pt markedly quadraparetic;could move head & speak w/o diff;CBC WNL;adm evolving GBS;intubated on ventilator;tracheostomy; |
|
VAERS ID: |
100352 (history) |
Form: |
Version 1.0 |
Age: |
63.0 |
Sex: |
Female |
Location: |
Florida |
Vaccinated: | 1994-09-29 |
Onset: | 1994-09-30 |
Days after vaccination: | 1 |
Submitted: |
1997-07-03 |
Days after onset: | 1007 |
Entered: |
1997-07-18 |
Days after submission: | 15 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS |
- / 2 |
- / - |
Administered by: Private Purchased by: Other Symptoms: Myelitis,
Neuropathy,
Paralysis SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Immune-mediated/autoimmune disorders (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: ~ ()~~~In patient Other Medications: unk Current Illness: unk Preexisting Conditions: hx of non-insulin dependent diabetes mellitus, hypothyroidism, chronic back pain synd, prev flu vax 6NOV92; Allergies: Diagnostic Lab Data: 12OCT96 EMG CDC Split Type: 010150970085001
Write-up: pt recv vax & exp transverse myelitis p''/vax;pt has not yet recovered, sx still persits;vax given 29SEP94;pt still exp transverse myelitis on 13OCT94;EMG performed on 12OCT96;3JUL97 related that became paralyzed p/vax; |
|
VAERS ID: |
100801 (history) |
Form: |
Version 1.0 |
Age: |
61.0 |
Sex: |
Female |
Location: |
Wisconsin |
Vaccinated: | 1993-10-15 |
Onset: | 1993-11-04 |
Days after vaccination: | 20 |
Submitted: |
1997-07-25 |
Days after onset: | 1358 |
Entered: |
1997-07-29 |
Days after submission: | 4 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS |
- / UNK |
- / IM |
Administered by: Other Purchased by: Other Symptoms: Amblyopia,
Eye disorder,
Eye haemorrhage,
Hypertension,
Laboratory test abnormal,
Neuropathy,
Visual disturbance,
Visual field defect SMQs:, Peripheral neuropathy (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Glaucoma (broad), Hypertension (narrow), Optic nerve disorders (broad), Lens disorders (broad), Corneal disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: NONE Current Illness: NONE Preexisting Conditions: no history of ocular pain, cephalgia, jaw cladication, or preceding illness;NKA;no hx of cat bite, or exposure to cats;no family hx of impaired vision; Allergies: Diagnostic Lab Data: The following tests were neg or nl: bilat temporal artery biopsy, MRI of brain & orbits w/ & w/o gadoliniu, lytes, BUN, creatine, alk phos, LDH, SOGT< GGT, SGTP, ESR< CBC, PT, PTT< lupus anticoagulant, Lyme titer, B-12, folate, flucose; CDC Split Type: 010150970125000
Write-up: pt devel visual loss in both eyes 3wk p/vax;4NOV93 noted blurring of both eyes rt $g lt;BP 130/100;pupillary defect;visual field testing revealed upper nasal island of vision;optic disc swollen & peripapillary hem;allerg react;neuropathy; |
|
VAERS ID: |
102181 (history) |
Form: |
Version 1.0 |
Age: |
|
Sex: |
Female |
Location: |
Virginia |
Vaccinated: | 1996-11-04 |
Onset: | 1996-11-05 |
Days after vaccination: | 1 |
Submitted: |
1997-05-16 |
Days after onset: | 191 |
Entered: |
1997-09-05 |
Days after submission: | 112 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH |
4968201 / UNK |
- / - |
Administered by: Other Purchased by: Other Symptoms: Dysphagia,
Eye disorder,
Facial palsy,
Lacrimal disorder SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Corneal disorders (broad), Retinal disorders (broad), Hearing impairment (broad), Lacrimal disorders (narrow)
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: ~ ()~~~In patient Other Medications: unk Current Illness: unk Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type: 897141003L
Write-up: 1 days p/vax pt devel Bell''s Palsy;As of 7MAY97 pt still exp facial paralysis, lt eye watered & would not close & had diff chewing & eating;no further info was available @ the date of this report; |
|
VAERS ID: |
102708 (history) |
Form: |
Version 1.0 |
Age: |
40.0 |
Sex: |
Female |
Location: |
Colorado |
Vaccinated: | 1996-10-01 |
Onset: | 1996-11-02 |
Days after vaccination: | 32 |
Submitted: |
1997-09-24 |
Days after onset: | 325 |
Entered: |
1997-09-26 |
Days after submission: | 2 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER |
- / 7+ |
- / A |
Administered by: Private Purchased by: Private Symptoms: Arthritis,
Neuropathy SMQs:, Peripheral neuropathy (narrow), Systemic lupus erythematosus (broad), Guillain-Barre syndrome (broad), Arthritis (narrow), Immune-mediated/autoimmune disorders (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: NONE Current Illness: NONE Preexisting Conditions: NONE Allergies: Diagnostic Lab Data: LP, MRI, Biopsy CDC Split Type:
Write-up: demyelinating peripheral neuropathy-both hands, both feet-misdiagnosed prev as arthritis; |
|
VAERS ID: |
102776 (history) |
Form: |
Version 1.0 |
Age: |
68.0 |
Sex: |
Female |
Location: |
Colorado |
Vaccinated: | 1993-10-01 |
Onset: | 1994-02-01 |
Days after vaccination: | 123 |
Submitted: |
1997-09-09 |
Days after onset: | 1315 |
Entered: |
1997-09-29 |
Days after submission: | 20 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH |
- / UNK |
- / IM |
Administered by: Private Purchased by: Other Symptoms: Ageusia,
Neuropathy,
Parosmia SMQs:, Peripheral neuropathy (narrow), Taste and smell disorders (narrow), Guillain-Barre syndrome (broad), Immune-mediated/autoimmune disorders (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: ~ ()~~~In patient Other Medications: NONE Current Illness: NONE Preexisting Conditions: recurrent facial shingles isnce 1945 which was treated w/x-ray therapy in 1945; Allergies: Diagnostic Lab Data: CT scans: reportedly negative;MRI''s reportedly negative; CDC Split Type: 897255006L
Write-up: pt recv vax in OCT93 & in FEB94 pt exp loss of taste & smell;CT scans & MRI were reportedly neg;pt stated that a specialist told her has olfactory nerve damage r/t flu shot; |
|
VAERS ID: |
104490 (history) |
Form: |
Version 1.0 |
Age: |
55.0 |
Sex: |
Female |
Location: |
Georgia |
Vaccinated: | 1996-11-01 |
Onset: | 1996-11-08 |
Days after vaccination: | 7 |
Submitted: |
1997-09-10 |
Days after onset: | 305 |
Entered: |
1997-11-10 |
Days after submission: | 61 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / MEDEVA PHARMA, LTD. |
E3036GA / UNK |
RA / IM |
Administered by: Private Purchased by: Public Symptoms: Antinuclear antibody,
Cerebrovascular accident,
Condition aggravated,
Headache,
Neuropathy,
Pain,
Paraesthesia,
Visual disturbance SMQs:, Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (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? Yes, 3 days
Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Novolin;Insulin;Cozar Current Illness: NONE Preexisting Conditions: diabetes Allergies: Diagnostic Lab Data: NA CDC Split Type: GA97124
Write-up: pt states on 8NOV96 pt had severe h/a-could not focus eyes-did not see MD on 18NOV97 onset of numbness lt leg, lt hand, lt side of face;saw MD was referred to MD & adm to hosp x 3 days;told had diabetic stroke;devel pain dx neuropathy; |
|
Vaccinated: | 0000-00-00 |
Onset: | 0000-00-00 |
Submitted: |
1997-10-24 |
Entered: |
1997-11-12 |
Days after submission: | 19 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH |
- / UNK |
- / - |
Administered by: Other Purchased by: Other Symptoms: Unevaluable event SMQs:
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: ~ ()~~~In patient Other Medications: unk Current Illness: unk Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type: 897302014L
Write-up: pt recv vax & exp injuries which will be w/pt throughout the rest of life; |
|