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This is VAERS ID 35526

Case Details

VAERS ID: 35526 (history)  
Form: Version 1.0  
Age: 55.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:1990-11-09
Onset:1990-11-24
   Days after vaccination:15
Submitted: 1991-06-07
   Days after onset:194
Entered: 1991-10-16
   Days after submission:131
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908194 / UNK - / -

Administered by: Other       Purchased by: Other
Symptoms: Asthenia, Guillain-Barre syndrome, Hypertension, Paraesthesia
SMQs:, Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (narrow), Hypertension (narrow), Demyelination (narrow), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 15 days
   Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: Pt recvd Hep B vax on 28SEP90 & 29OCT90;
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: A review of the batch record for lot# 4908194 was satisfactory w/no anomalies noted;
CDC Split Type: 890354001B

Write-up: Pt devel GBS p/receiving influenza vax; sx included numbness & tingling in hands, feet, & lt side of face; weakness in limbs; & elevation in BP; pt hospitalized on 24NOV90 & treated w/meds;


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