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This is VAERS ID 46276

Case Details

VAERS ID: 46276 (history)  
Form: Version 1.0  
Age: 81.0  
Sex: Female  
Location: Texas  
Vaccinated:1992-10-07
Onset:1992-10-08
   Days after vaccination:1
Submitted: 1992-10-14
   Days after onset:6
Entered: 1992-10-19
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 338971 / 1 LA / IM

Administered by: Other       Purchased by: Private
Symptoms: Aphasia, Encephalopathy, Grand mal convulsion, Paralysis
SMQs:, Systemic lupus erythematosus (broad), Dementia (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Generalised convulsive seizures following immunisation (narrow), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Nasalide, Megace, Theophyllin, Digoxin, K Ce, Lasix, Coumadin, Iron, ALbuterol inhaler, Atrovent;
Current Illness: breast cancer w/metasitasis, CHF
Preexisting Conditions: organic brain synd, recurrent deep vein thrombosis & pulmonar-embolism;
Allergies:
Diagnostic Lab Data: neg head CT x 2; neg LP; THeophylline level + digoxin levels non toxic;
CDC Split Type:

Write-up: seizures, grand mal w/in 12 hrs of vax; diffuse encephalopathy w/bilateral lower extremities & rt upper extremities paresis, aphasia;


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