| VAERS ID: |
36629 (history) |
| Form: |
Version 1.0 |
| Age: |
71.0 |
| Sex: |
Female |
| Location: |
Michigan |
| Vaccinated: | 1991-09-27 |
| Onset: | 1991-09-28 |
| Days after vaccination: | 1 |
| Submitted: |
1991-10-01 |
| Days after onset: | 3 |
| Entered: |
1991-11-25 |
| Days after submission: | 55 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH |
4918202 / UNK |
- / IM A |
Administered by: Public Purchased by: Public
Symptoms: Asthenia,
Cerebrovascular accident,
Hypertension,
Myasthenic syndrome,
Pneumonia,
Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Malignancy related conditions (narrow), Guillain-Barre syndrome (broad), Hypertension (narrow), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Immune-mediated/autoimmune disorders (narrow)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 8 days
Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: MS
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type:
Write-up: C/o lt sided weakness became weak, lost strength; BP 190/100, t103.5 treated & released @ ER 28SEP; hospitalized 4 days later w/pneumonia ? sl stroke; |
