National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 4/8/2021 release of VAERS data:

This is VAERS ID 132843



Case Details

VAERS ID: 132843 (history)  
Form: Version 1.0  
Age: 51.0  
Sex: Male  
Location: Nebraska  
Vaccinated:1999-11-03
Onset:1999-11-03
   Days after vaccination:0
Submitted: 1999-12-04
   Days after onset:31
Entered: 1999-12-27
   Days after submission:23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES U0186 / 6 RA / IM

Administered by: Private       Purchased by: Private
Symptoms: Diplopia, Influenza
SMQs:, Ocular motility disorders (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (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:
Current Illness: double vision and flu-like symptoms
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: EKG/ECG, MRI/brain, echo carotid, CT/head, cerv-spine obliques,mra head & neck
CDC Split Type:

Write-up: Received flu shot on 11/3/99 at 10:30 am and by 2:00 pm was experiencing double vision which is still occuring. Per follow-up, the pt is 95% recovered. Pt suffers from slight diplopia.


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=132843


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166