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This is VAERS ID 27178

Case Details

VAERS ID: 27178 (history)  
Form: Version 1.0  
Age: 53.0  
Sex: Male  
Location: California  
Vaccinated:1990-10-22
Onset:1990-10-27
   Days after vaccination:5
Submitted: 1990-12-18
   Days after onset:52
Entered: 1990-12-26
   Days after submission:8
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES - / UNK - / IM A

Administered by: Military       Purchased by: Private
Symptoms: Facial palsy, Hypoaesthesia, Myasthenic syndrome, Speech disorder
SMQs:, Peripheral neuropathy (broad), Dementia (broad), Malignancy related conditions (narrow), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hearing impairment (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: lumbar disc disease
Allergies:
Diagnostic Lab Data: Increased ACE level; LP increased protein, MRI 0, compatible w/savcoid
CDC Split Type:

Write-up: Pt vaccinated with Influenza onset peripheal hypesthesias, facial diplegia, dysphagia, leg weakness, resolved w/long course prednisone.


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