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This is VAERS ID 95597

Case Details

VAERS ID: 95597 (history)  
Form: Version 1.0  
Age: 78.0  
Sex: Female  
Location: Michigan  
Vaccinated:1996-10-08
Onset:1996-10-09
   Days after vaccination:1
Submitted: 1997-01-15
   Days after onset:98
Entered: 1997-03-10
   Days after submission:54
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4968172 / UNK RA / IM

Administered by: Public       Purchased by: Public
Symptoms: Asthenia, Back pain, Hypokinesia, Infection, Injection site pain, Neuralgia, Pain, Rhinitis
SMQs:, Peripheral neuropathy (narrow), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypotonic-hyporesponsive episode (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: pt son devel eczema as teenger p/flu vax;~ ()~~~In patient
Other Medications: NONE weekly allergy inj
Current Illness: NONE
Preexisting Conditions: allergies to tree, grass & molds;no food allergies;
Allergies:
Diagnostic Lab Data:
CDC Split Type: MI97009

Write-up: pt devel weakness (total body) 9OCT96 AM;pain localized to upper rt arm (?deltoid muscle);felt like tightness-nerve pain that radiated to back (rt scapula area over the next few days);pain went up into face;saw MD-sinus infect/teeth p


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