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This is VAERS ID 29350

Case Details

VAERS ID: 29350 (history)  
Form: Version 1.0  
Age: 66.0  
Sex: Female  
Location: Colorado  
Vaccinated:1990-11-07
Onset:1990-11-10
   Days after vaccination:3
Submitted: 1991-03-22
   Days after onset:132
Entered: 1991-03-25
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 025808 / 4 - / A

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? Yes
   Date died: 1990-11-29
   Days after onset: 19
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 49 days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Dyazide
Current Illness: NONE
Preexisting Conditions: Hypertension, mild
Allergies:
Diagnostic Lab Data: MRI & convalescent serum consistent
CDC Split Type:

Write-up: Three days p/flu shot was given, pt came down w/what was consistent w/Herpes encephalitis; Autopsy also consistent with Herpes; Does not think encephalitis was related to "flu shot";


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