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This is VAERS ID 476382

Case Details

VAERS ID: 476382 (history)  
Form: Version 1.0  
Age: 73.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2012-10-09
Onset:2012-10-12
   Days after vaccination:3
Submitted: 2012-12-04
   Days after onset:53
Entered: 2012-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE) / SANOFI PASTEUR U4525AA / UNK LA / IM

Administered by: Other       Purchased by: Other
Symptoms: Abasia, Biopsy, Biopsy bone marrow, Blood test, Computerised tomogram, Nuclear magnetic resonance imaging, Sensory loss, X-ray
SMQs:, Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2012-12-01
   Days after onset: 50
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 34 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vasodec, HTZ/lisinopril
Current Illness: None
Preexisting Conditions: Hypertension
Allergies:
Diagnostic Lab Data: CT, MRI, (multiple) biopsies, blood tests, bone marrow biopsy, multiple x rays
CDC Split Type:

Write-up: Started losing all feeling in arms and legs. Unable to walk unassisted.


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