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From the 4/8/2021 release of VAERS data:

This is VAERS ID 59120



Case Details

VAERS ID: 59120 (history)  
Form: Version 1.0  
Age: 62.0  
Sex: Female  
Location: Arizona  
Vaccinated:1993-11-28
Onset:1993-12-11
   Days after vaccination:13
Submitted: 1993-12-21
   Days after onset:10
Entered: 1994-01-18
   Days after submission:28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4938278 / UNK - / IM A

Administered by: Other       Purchased by: Private
Symptoms: Asthenia, Cardiovascular disorder, Dysphagia, Dyspnoea, Guillain-Barre syndrome, Neck pain, Neuropathy, Paraesthesia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Demyelination (narrow), Arthritis (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
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: unk
Current Illness: unk
Preexisting Conditions: hx of labile hypertension, uterine cancer--rx''d in 1975, hysterectomy, osteoporosis, acute herniated disc--rx''d w/epidural blocks; allergic to sulfa drugs & possibly Demerol;
Allergies:
Diagnostic Lab Data:
CDC Split Type: 893357001J

Write-up: pt recvd flu vax 28NOV93 & approx 14DEC93 began to devel sx of GBS; remains hospitalized as the date of this report in stable condition;


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