| VAERS ID: |
134119 (history) |
| Form: |
Version 1.0 |
| Age: |
36.0 |
| Sex: |
Male |
| Location: |
Arizona |
| Vaccinated: | 1998-11-16 |
| Onset: | 1998-11-16 |
| Days after vaccination: | 0 |
| Submitted: |
2000-02-07 |
| Days after onset: | 448 |
| Entered: |
2000-02-16 |
| Days after submission: | 9 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| ANTH: ANTHRAX (NO BRAND NAME) / MICHIGAN DEPT PUB HLTH |
- / UNK |
- / - |
| FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER |
- / UNK |
- / IM |
Administered by: Military Purchased by: Military
Symptoms: Agitation,
Hyperthyroidism,
Insomnia,
Tremor,
Weight decreased
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Hyperthyroidism (narrow), 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? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:
Write-up: Developed a hyperactive thyroid. Lost weight (25 lbs), sleep loss, shaking, irritable, etc. Dx, Graves Disease. |
