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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)

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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