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This is VAERS ID 39896

Case Details

VAERS ID: 39896 (history)  
Form: Version 1.0  
Age: 77.0  
Sex: Male  
Location: Texas  
Vaccinated:1990-09-24
Onset:1990-10-06
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 1992-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / UNK - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: CSF test abnormal, Guillain-Barre syndrome, Hypokinesia, Paralysis, Paraplegia
SMQs:, Peripheral neuropathy (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Demyelination (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypotonic-hyporesponsive episode (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: pt had resection of abdominal aneurysm 4 yrs ago & CABG 6 yrs ago;
Allergies:
Diagnostic Lab Data:
CDC Split Type: 904090005

Write-up: GBS is reported in a pt who recvd flu vax; 12 days p/inject, pt had sudden paralysis & became paraplegic w/loss of motor & sensory neurological function below the level of T12; pt hospitalized & tx w/meds; MD expect recovery;


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