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This is VAERS ID 43188

Case Details

VAERS ID: 43188 (history)  
Form: Version 1.0  
Age: 40.0  
Sex: Male  
Location: Unknown  
Vaccinated:1991-10-01
Onset:1991-10-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1992-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 1J21118 / UNK - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Myositis, Neuritis
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NA
Current Illness: NA
Preexisting Conditions: NA
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: post vax neuritis; post vax myositis lt deltoid muscle;


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