National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 55821

Case Details

VAERS ID: 55821 (history)  
Form: Version 1.0  
Age: 59.0  
Sex: Male  
Location: Michigan  
Vaccinated:1992-10-05
Onset:1992-10-25
   Days after vaccination:20
Submitted: 1993-07-25
   Days after onset:273
Entered: 1993-09-07
   Days after submission:44
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928136 / UNK LA / IM

Administered by: Private       Purchased by: Other
Symptoms: Myelitis, Neuropathy
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Immune-mediated/autoimmune disorders (broad)

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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: MRI x 4; LP lab;
CDC Split Type: MI93120

Write-up: pt recvd vax 5OCT92 & devel neurological s/s T11-T12 26OCT92; MRI''s, LP lab etc; dx acute transverse myelitis w/profound neurological residue; deficit still present 10 months later;


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=55821


Copyright © 2020 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166