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This is VAERS ID 48049

Case Details

VAERS ID: 48049 (history)  
Form: Version 1.0  
Age: 84.0  
Sex: Female  
Location: New York  
Vaccinated:1992-10-22
Onset:1992-10-22
   Days after vaccination:0
Submitted: 1992-10-23
   Days after onset:1
Entered: 1992-12-14
   Days after submission:52
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928241 / 6 LA / -

Administered by: Public       Purchased by: Public
Symptoms: Cerebral haemorrhage, Paralysis, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Haemorrhage terms (excl laboratory terms) (narrow), Arrhythmia related investigations, signs and symptoms (broad), Haemorrhagic central nervous system vascular conditions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: dx: intracerebral hemorrhage; no evidence seen by MD of hypersensitivity rxn to vax;
CDC Split Type: BA92001

Write-up: loss of consciousness, paralysis;


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