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This is VAERS ID 25634

Case Details

VAERS ID: 25634 (history)  
Form: Version 1.0  
Age:   
Sex: Female  
Location: California  
Vaccinated:1989-01-01
Onset:1989-11-30
   Days after vaccination:333
Submitted: 0000-00-00
Entered: 1990-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01889P / UNK - / IM

Administered by: Private       Purchased by: Unknown
Symptoms: Coma, Hypoglycaemia
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (narrow)

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: Vitamin B12 injections
Current Illness:
Preexisting Conditions: pt was elderly /w a hx of pernicious anemia
Allergies:
Diagnostic Lab Data: BS = 20mg/100ml
CDC Split Type: 904089020

Write-up: Pt received Fluogen within 30 min experienced coma & Hypoglycemia; Blood sugar 20 mg/100 ml; No other reports of this nature on the lot.


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