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This is VAERS ID 35494

Case Details

VAERS ID: 35494 (history)  
Form: Version 1.0  
Age: 57.0  
Sex: Male  
Location: Mississippi  
Vaccinated:1991-09-25
Onset:1991-09-26
   Days after vaccination:1
Submitted: 1991-10-10
   Days after onset:14
Entered: 1991-10-15
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / 1 - / IM A

Administered by: Private       Purchased by: Private
Symptoms: Facial palsy
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (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: NONE~ ()~~~In patient
Other Medications: Lasix, Hybin
Current Illness: HBP, Prostate Hypertrophy
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Bells Palsy devel 2 days p/receiving vax;


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