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This is VAERS ID 36479

Case Details

VAERS ID: 36479 (history)  
Form: Version 1.0  
Age: 55.0  
Sex: Female  
Location: California  
Vaccinated:1990-10-31
Onset:1990-11-14
   Days after vaccination:14
Submitted: 1991-01-16
   Days after onset:63
Entered: 1991-11-19
   Days after submission:307
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 11222 / 1 LA / -

Administered by: Public       Purchased by: Public
Symptoms: Asthenia, Guillain-Barre syndrome, Hyperaesthesia, Hypotension, Myalgia, Paraesthesia, Speech disorder, Visual disturbance
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Glaucoma (broad), Optic nerve disorders (broad), Demyelination (narrow), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 16 days
   Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: Premarin/Provera, Inderal
Current Illness: NONE
Preexisting Conditions: Hypertension, migraines, tremor in lt hand for 15 hrs controlled by inderal;
Allergies:
Diagnostic Lab Data: LP x 1 28NOV MRI head/neck in hosp; 23DEC MRI head, to be repeated in April, Blood test in hosp thinks Ca & K was low; pt doesn''t have results;
CDC Split Type: CA91126

Write-up: 14NOV90 tingling & cold hands & feet; 16NOV90 Seen by MD tingling, hypersensitive to touch, no response to knee reflex, tired; 22NOV90 unable to eat much, trouble ambulating, slurred speech, vision problems; poss GBS, backache, low BP;


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