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This is VAERS ID 34575

Case Details

VAERS ID: 34575 (history)  
Form: Version 1.0  
Age:   
Sex: Female  
Location: Florida  
Vaccinated:1989-10-15
Onset:1989-10-15
   Days after vaccination:0
Submitted: 1991-08-27
   Days after onset:681
Entered: 1991-09-06
   Days after submission:10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01899P / UNK - / IM

Administered by: Other       Purchased by: Other
Symptoms: Amnesia, Arthralgia, Arthritis, Coordination abnormal, Dizziness, Myalgia, Paralysis
SMQs:, Rhabdomyolysis/myopathy (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Vestibular disorders (broad), Arthritis (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type: 914089003

Write-up: Joint paralysis, arthritic-like sz, loss of memory & loss of equilibrium & accompanying dizziness & unspecified various muscular & skeletal pains reported by husband of pt receiving Fluogen; Vax recvd on 15OCT89;


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