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This is VAERS ID 38092

Case Details

VAERS ID: 38092 (history)  
Form: Version 1.0  
Age: 44.0  
Sex: Female  
Location: Montana  
Vaccinated:1991-10-31
Onset:1991-11-05
   Days after vaccination:5
Submitted: 1991-11-26
   Days after onset:21
Entered: 1991-12-23
   Days after submission:27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918147 / 1 - / -

Administered by: Public       Purchased by: Public
Symptoms: Guillain-Barre syndrome, Myasthenic syndrome, Peroneal nerve palsy
SMQs:, Peripheral neuropathy (narrow), Malignancy related conditions (narrow), Guillain-Barre syndrome (narrow), Demyelination (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 21 days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data:
CDC Split Type: 891331002J

Write-up: Pt devel GBS 5 days p/receiving flu vax; additional info has been requested;


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