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This is VAERS ID 46114

Case Details

VAERS ID: 46114 (history)  
Form: Version 1.0  
Age: 67.0  
Sex: Female  
Location: Louisiana  
Vaccinated:1991-11-01
Onset:1991-11-16
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 1992-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 1F21219 / 1 RA / -

Administered by: Public       Purchased by: Public
Symptoms: Back pain, Hyperaesthesia, Hyperglycaemia, Hypochromic anaemia, Laboratory test abnormal, Leukopenia, Neuropathy, Pneumonia
SMQs:, Haematopoietic leukopenia (narrow), Peripheral neuropathy (narrow), Hyperglycaemia/new onset diabetes mellitus (narrow), Systemic lupus erythematosus (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 7 days
   Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: HGB-11.5; HCT 35.4, RDW 16.1;
CDC Split Type: LA921004

Write-up: about 2 wks p/shot woke up 2AM w/severe pain lower back & rt leg to knee 16NOV91; pt went to ER & adm to hosp seen by bone & joint specialist; nerve problem, glucose of 136; meralgia paresthetica; pneumonia, Hgb 11.5, WBC 4,500;


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