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This is VAERS ID 39899

Case Details

VAERS ID: 39899 (history)  
Form: Version 1.0  
Age: 50.0  
Sex: Female  
Location: Missouri  
Vaccinated:1989-10-15
Onset:1989-10-25
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 1992-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01209P / UNK - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Asthenia, Guillain-Barre syndrome, Hypertonia
SMQs:, Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Parkinson-like events (narrow), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Demyelination (narrow), Hypokalaemia (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Calan, Zantac, Zestril, & HCTZ & KCL;
Current Illness:
Preexisting Conditions: Diet controlled NIDDM prior to GBS, now on insulin; flu shot in past w/out sequelae;
Allergies:
Diagnostic Lab Data:
CDC Split Type: 914090006

Write-up: GBS reported in pt who recvd flu vax & 10 days p/flu shot pt was hospitalized for rapid progression of weakness; CT scan suggested surgical etiology for GBS; pt still exp muscle spasms;


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