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This is VAERS ID 31380

Case Details

VAERS ID: 31380 (history)  
Form: Version 1.0  
Age: 61.0  
Sex: Male  
Location: Connecticut  
Vaccinated:1990-09-28
Onset:1990-10-10
   Days after vaccination:12
Submitted: 1991-06-12
   Days after onset:245
Entered: 1991-06-17
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / 1 LA / -

Administered by: Private       Purchased by: Private
Symptoms: CSF test abnormal, Guillain-Barre syndrome, Myasthenic syndrome
SMQs:, Peripheral neuropathy (narrow), Malignancy related conditions (narrow), Guillain-Barre syndrome (narrow), Demyelination (narrow), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Cardizem
Current Illness: HTN, ASHD
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: spinal tap showing elevated protein
CDC Split Type:

Write-up: Pt recvd vax 28SEP90. Pt developed progressive muscle weakness. Hospitalized 11OCT90 w/acute Guillian-Barre Synd. The pt required plasmapheresis & respirator support.


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