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This is VAERS ID 59775

Case Details

VAERS ID: 59775 (history)  
Form: Version 1.0  
Age: 70.0  
Sex: Female  
Location: Maine  
Vaccinated:1993-08-31
Onset:1993-09-05
   Days after vaccination:5
Submitted: 1994-01-04
   Days after onset:121
Entered: 1994-02-09
   Days after submission:36
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / IM A

Administered by: Private       Purchased by: Private
Symptoms: Asthenia, CSF test abnormal, Guillain-Barre syndrome, Muscle atrophy, Neuropathy, Pain, Quadriplegia, Thinking abnormal
SMQs:, Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Demyelination (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 90 days
   Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Synthroid; Glynase 1.5 mg; Relafen 500 mg;
Current Illness: NONE
Preexisting Conditions: pt is diabetic; allergic to penicillin & sulfa; has hypertension, hypercalcemia, obesity, hypercholesterolemia, hematuria, proteinuria; s/p rt arm tumor resection in 1980 & throidectomy for malignant nodule in 1970''s;
Allergies:
Diagnostic Lab Data:
CDC Split Type: 894024001J

Write-up: pt recvd vax SEP93 & devel nausea & vomiting; the next day devel severe pain in both shoulder & throughout body; subsequently lost the use of arms; adm to hosp where was given a dx of GBS;


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