National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 6/11/2021 release of VAERS data:

This is VAERS ID 406908



Case Details

VAERS ID: 406908 (history)  
Form: Version 1.0  
Age: 74.0  
Sex: Female  
Location: California  
Vaccinated:2010-10-22
Onset:2010-10-24
   Days after vaccination:2
Submitted: 2010-11-03
   Days after onset:10
Entered: 2010-11-04
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR UT3621GA / UNK UN / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 0632Y / UNK UN / IM

Administered by: Other       Purchased by: Private
Symptoms: Blood creatine phosphokinase increased, Blood urea increased, Chest X-ray, Dysaesthesia, Full blood count, Hypoaesthesia, Metabolic function test, Muscular weakness, Pain in extremity, Paraesthesia, Red blood cell sedimentation rate increased, White blood cell count increased
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2010-11-09
   Days after onset: 16
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 10 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: HCTZ; Atenolol; Lisinopril; Zolpidem; Simvastatin; Nortriptyline
Current Illness: None
Preexisting Conditions: PCN -allergy; HTN; Diabetes
Allergies:
Diagnostic Lab Data: 10/31/10 CXR done CBC; WBC 14.0; CMP with CK of 263; BUN -29; Sed Rate 53; Transferred to hospital - higher level of care with dx of R/o Guillian Barre Syndrome
CDC Split Type:

Write-up: Numbness, pain bilateral lower extremities progressive weakness, tingling, dyesthesias in soles of feet - started on 10/24 seen at clinic on 10/26 - started on LYRICA d/t hx of diabetes seen in ER on 10/31 - with dyesthesias in hands and fingers - transferred to different hospital.


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=406908


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166