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This is VAERS ID 99006

Case Details

VAERS ID: 99006 (history)  
Form: Version 1.0  
Age: 73.0  
Sex: Male  
Location: Unknown  
Vaccinated:1996-10-02
Onset:1996-10-05
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 1997-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4968185 / UNK - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Laboratory test abnormal, Muscle atrophy, Neuropathy, Pain
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Prilosec & propulsid on reg basis
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: EMG affected on axillary suprascapular, median nerves;
CDC Split Type:

Write-up: lt arm pain-same arm as flu shot;supra? deltoid atrophy;EMG affected on axillary suprascapular, median nerve;


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