VAERS ID: |
28476 (history) |
Form: |
Version 1.0 |
Age: |
28.0 |
Sex: |
Male |
Location: |
North Carolina |
Vaccinated: | 1990-09-27 |
Onset: | 1990-09-28 |
Days after vaccination: | 1 |
Submitted: |
0000-00-00 |
Entered: |
1991-02-26 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH |
4908193 / UNK |
- / IM |
Administered by: Unknown Purchased by: Unknown Symptoms: Asthenia,
Headache,
Influenza,
Paraesthesia,
Paralysis SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Infective pneumonia (broad), Opportunistic infections (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? Yes, ? days
Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type:
Write-up: Developed headache & flu-like sx for approx 2 days followed by slight numbness of hands & feet. Developed weakness that progressed to paralysis. |