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This is VAERS ID 26596

Case Details

VAERS ID: 26596 (history)  
Form: Version 1.0  
Age: 80.0  
Sex: Female  
Location: California  
Vaccinated:1990-10-01
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 1990-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 289967 / UNK - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Convulsion, Encephalitis, Stupor
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (narrow), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: 900180401

Write-up: Pt vaccinated with Influenza Vaccine 3-4 days after, pt had a seizure like episode at home, was found unresponsive and hospitalized. Admitted to ICU for 5 days. Treatment included oxygen and IV fluids. Discharged, admitted to Nursing Home.


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