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This is VAERS ID 36611

Case Details

VAERS ID: 36611 (history)  
Form: Version 1.0  
Age: 56.0  
Sex: Female  
Location: Missouri  
Vaccinated:1991-10-31
Onset:1991-11-09
   Days after vaccination:9
Submitted: 1991-11-15
   Days after onset:6
Entered: 1991-11-25
   Days after submission:10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918146 / 1 LA / IM

Administered by: Public       Purchased by: Public
Symptoms: Dysphagia, Guillain-Barre syndrome, Hypokinesia, Myalgia, Myasthenic syndrome, Paraesthesia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Malignancy related conditions (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Demyelination (narrow), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Tendinopathies and ligament disorders (broad)

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, 1 days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Advil, Cardizem
Current Illness: NONE
Preexisting Conditions: arthritis; hyperderssion sinc 3; hypothyroidism, allergic to PCN
Allergies:
Diagnostic Lab Data: CBC-normal; p-3.6; otherwise chem normal; Electormogram; CSF; GM slain-neg; smear fangus-neg; glucose; protein, APT; electrolytes, SGPT, total CPK, sigmoid; LP revealed mild inc in portein in spinal fluid & GBS dx; CXR-normal
CDC Split Type: MO9190

Write-up: 9NOV91 numbness & tingling lower extremities; 10NOV91 could no longer stand; arms have movement but weak;grasp weak, vomiting, muscular pain, some difficulty swallowing;


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