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This is VAERS ID 27162

Case Details

VAERS ID: 27162 (history)  
Form: Version 1.0  
Age: 44.0  
Sex: Male  
Location: Unknown  
Vaccinated:1990-11-20
Onset:1990-12-09
   Days after vaccination:19
Submitted: 1990-12-18
   Days after onset:9
Entered: 1990-12-26
   Days after submission:8
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Private       Purchased by: Private
Symptoms: Encephalitis
SMQs:, Noninfectious encephalitis (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
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: Spinal Tap increased Lymphs, CT, MRI WNL
CDC Split Type:

Write-up: Pt vaccinated developed acute encephalo-myelitis


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