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This is VAERS ID 48167

Case Details

VAERS ID: 48167 (history)  
Form: Version 1.0  
Age: 62.0  
Sex: Male  
Location: Florida  
Vaccinated:1992-10-20
Onset:1992-10-24
   Days after vaccination:4
Submitted: 1992-11-17
   Days after onset:24
Entered: 1992-12-17
   Days after submission:30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 00192P / 3 LA / IM

Administered by: Public       Purchased by: Public
Symptoms: Guillain-Barre syndrome
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Demyelination (narrow), Immune-mediated/autoimmune disorders (narrow)

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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Mevacor, Vitamins
Current Illness: NONE
Preexisting Conditions: ASHD, S/PCABG
Allergies:
Diagnostic Lab Data: LP, EMG;
CDC Split Type: FL92076

Write-up: Guillain Barre syndrome;


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