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This is VAERS ID 50178

Case Details

VAERS ID: 50178 (history)  
Form: Version 1.0  
Age: 63.0  
Sex: Female  
Location: New York  
Vaccinated:1992-10-20
Onset:1992-10-21
   Days after vaccination:1
Submitted: 1992-11-17
   Days after onset:27
Entered: 1993-02-18
   Days after submission:93
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / 7+ - / IM A

Administered by: Private       Purchased by: Other
Symptoms: Pain, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: 892338003K

Write-up: pt recvd flu vax & exp pain in the arm of inject from neck to the hand; pt continues to have pain 1 mo p/vax;


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