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This is VAERS ID 35111

Case Details

VAERS ID: 35111 (history)  
Form: Version 1.0  
Age: 15.0  
Sex: Female  
Location: Indiana  
   Days after vaccination:1
Submitted: 1990-11-12
   Days after onset:741
Entered: 1991-09-30
   Days after submission:321
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Private       Purchased by: Other
Symptoms: Gait disturbance, Guillain-Barre syndrome, Headache, Hyporeflexia, Influenza, Myalgia, Myasthenic syndrome, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Malignancy related conditions (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (narrow), Demyelination (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (narrow)

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? Yes, 55 days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Diagnostic Lab Data: Cytomegalovirus titer were found to be positive; 15DEC88 Gluscose-86, Protein-122; CMV titer $g=160-pos; 12DEC88 ESR-50; 2JAN89 ESR 33; Motor Nerve conduction Velocities-peroneal motor nerve of 39 w/low amplitude response;
CDC Split Type: 890318005B

Write-up: Approx 1wk post vax, pt devel flu-like illness, felt run down, h/a; Seen by MD felt sinus h/a; 11DEC88 admitted to Hosp; sx included muscle weakness, gait disturbances, facial weakness, rt shoulder pain, neck stiffness, sensory loss, GBS;

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