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This is VAERS ID 49045

Case Details

VAERS ID: 49045 (history)  
Form: Version 1.0  
Age: 69.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:1992-11-06
Onset:1992-11-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1993-01-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928217 / UNK - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Diplopia, Eyelid ptosis, Guillain-Barre syndrome, Headache, Visual disturbance
SMQs:, Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Guillain-Barre syndrome (narrow), Glaucoma (broad), Optic nerve disorders (broad), Demyelination (narrow), Lens disorders (broad), Retinal disorders (broad), Periorbital and eyelid disorders (narrow), Ocular motility disorders (narrow), Hypoglycaemia (broad), 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: Ecotrin, Tagamet
Current Illness:
Preexisting Conditions: Gastroesophageal reflux dis, hypercholesterolemia, hx of anxiety disorder, stable abdo aortic aneurysm;
Allergies:
Diagnostic Lab Data: CSF-appearance was transparent & acellular present material neg for malignant cells;
CDC Split Type:

Write-up: pt exp diplopia & frontal h/a 1 day p/receiving flu vax followed by diminished visual acuity in lt eye & lt ptosis; poss GBS;


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