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This is VAERS ID 25171

Case Details

VAERS ID: 25171 (history)  
Form: Version 1.0  
Age:   
Sex: Female  
Location: New Jersey  
Vaccinated:1989-12-01
Onset:1989-12-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Private       Purchased by: Private
Symptoms: Arthralgia, Neuropathy
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Arthritis (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE---IVV WAS A TRIVALENT A&B 1989-1990 FORMULA
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: B073090037

Write-up: PT EXPER.ARTHRITIC PAIN AND POLYNEUROPATHY AFTER ADMIN OF INFLUENZA VIRUS VACCINE. REPORTER NOT SURE IF WYETH OF PARKE-DAVIS PRODUCT WAS USED.


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