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This is VAERS ID 66695

Case Details

VAERS ID: 66695 (history)  
Form: Version 1.0  
Age: 44.0  
Sex: Female  
Location: Michigan  
Vaccinated:1993-10-28
Onset:1993-11-01
   Days after vaccination:4
Submitted: 1993-11-15
   Days after onset:14
Entered: 1994-09-09
   Days after submission:297
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / PFIZER/WYETH - / UNK LA / IM

Administered by: Private       Purchased by: Other
Symptoms: Condition aggravated, Myasthenic syndrome, Neuropathy, Pain
SMQs:, Peripheral neuropathy (narrow), Malignancy related conditions (narrow), Guillain-Barre syndrome (broad), Immune-mediated/autoimmune disorders (narrow)

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: NA~ ()~~~In patient
Other Medications: NA
Current Illness: on re-exam pt recovered from bronchitis
Preexisting Conditions: h/o elevated enzymes; rt hip neurosis; hypothyroid; intermittant hematurai & alport''s synd (congenital renal disease); non-drinker; poss dx carpal tunnel synd related to occupation or GBS;
Allergies:
Diagnostic Lab Data: EMG lt ulner neuropathy 10NOV93; (pt is lt hand dominant); pos tunnel synd 18NOV93; c-spine nl;
CDC Split Type: 930244601

Write-up: w/in 2-3 days p/vax pt had shoulder pain; however, had no inject site react; neuro consult was obtained EMG done 10NOV93 dx lt ulnar neuropathy; pt lost grip in lt hand 15NOV


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