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This is VAERS ID 94613

Case Details

VAERS ID: 94613 (history)  
Form: Version 1.0  
Age: 72.0  
Sex: Female  
Location: Virginia  
Vaccinated:1996-11-25
Onset:1997-01-06
   Days after vaccination:42
Submitted: 1997-01-22
   Days after onset:16
Entered: 1997-02-03
   Days after submission:12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4968170 / 7+ RA / IM

Administered by: Public       Purchased by: Public
Symptoms: CSF test abnormal, Myelitis, Paraesthesia, Paraplegia
SMQs:, Peripheral neuropathy (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (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? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: Cordizen, Insulin, Trental
Current Illness: diabetes, HTN, periph vasc disease
Preexisting Conditions: diabetes, HTN, peripheral vascular disease
Allergies:
Diagnostic Lab Data: CSF w/elevated protein otherwise negative x/for few WACS;MRI w/ inc signal for T5-T10;
CDC Split Type: VA97036

Write-up: dx w/acute transverse myelitis-hosp from 9JAN97-17JAN97 then transported to a rehab facility w/lower extremities paraplegic & numbness up to T4/t% level;


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