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This is VAERS ID 26716

Case Details

VAERS ID: 26716 (history)  
Form: Version 1.0  
Age: 53.0  
Sex: Female  
Location: Colorado  
Vaccinated:1990-10-24
Onset:1990-11-05
   Days after vaccination:12
Submitted: 1990-11-15
   Days after onset:10
Entered: 1990-11-26
   Days after submission:11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908201 / UNK - / IM A

Administered by: Other       Purchased by: Other
Symptoms: Asthenia, Dysphagia, Guillain-Barre syndrome, Neck pain, Pain, Paraesthesia, Paralysis
SMQs:, Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Demyelination (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Arthritis (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Elevated CSF protein
CDC Split Type:

Write-up: Pt vaccinated with Influenza c/o severe neck & throat pain spreaded down resulting in generalized weakness & arm numbness. Admitted to hosp w/proximal weakness & difficulty swollowing & paralysis. Probable GBS.


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